Background: In recent years posterior corneal astigmatism and its effect on total corneal astigmatism has been studied, with research showing that this can impact total astigmatism. This study aims to ascertain if there is significant change in the posterior corneal astigmatism after cataract surgery and its impact on the total astigmatism.

Methods: Analysis of 76 eyes that underwent cataract surgery with monofocal intraocular lens implantation. Corneal topography was performed with Pentacam (OCULUS^?) pre- and post-operatively. Total corneal astigmatism was calculated with the algorithm of vergence tracing. We compared preoperative and postoperative changes in the magnitude and axis differences of anterior corneal curvature astigmatism, posterior corneal curvature astigmatism and the calculated total corneal astigmatism. We calculated the correlation between the total preoperative astigmatism and the difference between total corneal astigmatism and anterior corneal astigmatism.

Results: The mean preoperative and postoperative posterior astigmatism was 0.31±0.02 D, showing no significant differences before and after surgery (P=0.989). Statistically significant differences between the calculated total corneal astigmatism and anterior corneal astigmatism were registered preoperatively and postoperatively in the with-the-rule anterior (WTR) corneal astigmatism (P=0.004, P<0.0001); against-the-rule (ATR) anterior corneal astigmatism (P<0.0001, P<0.0001) and in the oblique (P=0.026, P=0.019) subgroups. The posterior corneal astigmatism and the total corneal astigmatism correlated positively with the differences between the total corneal and anterior corneal astigmatism (R=0.378, P=0.001).

Conclusions: There were statistically significant differences between the magnitude of the total astigmatism and anterior corneal astigmatism, underlining the impact of posterior corneal astigmatism. A positive correlation between the preoperative posterior astigmatism and the difference between the total corneal and the anterior corneal astigmatism suggests a specially relevant role of posterior corneal astigmatism when evaluating patients with higher degrees of astigmatism.

Background: Patching an eye for a period of 2 hours results in a period of plasticity where inter-ocular balance shifts in favor of the patched eye. Acetylcholine has been shown to improve visual function and augment adult neural plasticity. Here we evaluate whether administering the cholinesterase inhibitor donepezil enhances the magnitude or duration of the patching induced shift in ocular balance.

Methods: We used a double-blind drug treatment design to test the effect of donepezil and patching on the shift in ocular balance. We used a well-known binocular phase combination task to measure ocular balance before and after treatment.

Results: Our results demonstrate that donepezil does not enhance, and may actually reduce the magnitude and duration of the patching-induced shift in ocular balance.

Conclusions: Patching induced adult neural plasticity does not appear to be modulated by the cholinergic system, however, increased dose or longer drug administration periods may yield significant results. Future studies on binocular rivalry are in the pipeline.