Corneal astigmatism in leprosy and its importance for cataract surgery

Background: In leprosy, the eyes are frequently affected and many patients were found to have a higher degree of corneal astigmatism than expected during their routine cataract work up. Aim: To compare pre-existing (before any surgical intervention) corneal astigmatism in leprosy patients as compared to age-matched normal controls. Methods: A retrospective study was done, using the charts of leprosy patients and age-matched controls without leprosy, who had undergone cataract surgery between 2009 and 2013. The pre-existing astigmatism of the patients in both the groups was compared and analysed. Results: Severe and very severe astigmatism did not occur in the non-leprosy group, but was found in 6·5% of the eyes of patients in the leprosy group. The difference between the groups was significant (x 1⁄4 21·68, P 1⁄4 0·0001). Conclusion: Pre-existing corneal astigmatism is significantly more severe in leprosy patients than in non-leprosy patients being prepared for cataract surgery. This knowledge helped us to customise the cataract surgery in order to achieve a better outcome.