Aim: To assess the impact of posterior corneal asphericity on postoperative astigmatism.

Methods: We included retrospectively 70 eyes of 70 patients that underwent cataract surgery. We included data of the Q value, K max, K1, K2, astigmatism AL, and ACD. We performed a vectorial analysis to calculate the astigmatic vectors.

Results: Seventy eyes were evaluated. 40 eyes were of females (58%) and 30 of males (42%). The average cohort age was 73 ± 8.9 years. Axial length (AL) was 23.5 ± 0.9, anterior chamber depth (ACD) was 3.13 ± 0.3, and the average posterior Q value was -0.35 ± 0.2. The only significant predictive variable for the correction index (CI) was the posterior Q value (r = 0.24, p < 0.05) and for the surgically induced astigmatism (SIA) (β = 0.34, r = 0.58, p < 0.05).

Conclusion: Posterior corneal surface asphericity significantly influences the surgically induced astigmatism and the overcorrection for cataract patients after Lucidis EDOF IOL implantation.