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To evaluate the corneal spherical aberrations in cataract patients with and without high myopia, we conducted a retrospective case series of 502 cataract eyes with high myopia and 1500 age-related cataract eyes and measure their corneal biometric data and axial length using Pentacam and IOLMaster. Both the anterior and total corneal primary spherical aberrations were lower in the high myopia group than that in the control group (0.317 ± 0.215 vs 0.338 ± 0.148 μm,  P  = 0.043; and 0.281 ± 0.207 vs 0.314 ± 0.153 μm,  P  < 0.001). The incidence of eyes with negative total corneal primary spherical aberration increased as axial length increased in the high myopia group, and the overall incidence was higher in the high myopia group than that in the control group (2.59% vs 1.47%). These were mainly contributed to the younger age of cataract patients with high myopia (55.76 ± 13.10 vs 60.18 ± 15.72 years,  P  < 0.001), along with the positive correlations between age and anterior and total corneal primary spherical aberrations. In clinical practice, an aspheric IOL with a low negative or zero primary spherical aberration is recommended for cataract patients with high myopia. Negative total ocular primary spherical aberrations resulting from aspheric IOL implantation should be avoided in extremely high myopic eyes.

Analysis of Corneal Spherical Aberrations in Cataract Patients with High Myopia