Remarkable postcataract against-the-rule astigmatism after phacoemulsification in 83 of 809 cases

We analyzed 83 cases of remarkable postcataract against-the-rule (AR) astigmatism (greater than 1.5D) occurring in a total of 809 Kelman's phacoemulsification aspiration procedures, all using 10-0 polyester sutures in a double-running fashion to close the corneoscleral incisions. All operations were done by one surgeon, using the same surgical procedure and the same number of sutures. The induction and spontaneous regression of several types of astigmatism were analyzed over six months. In cases of preoperative oblique and AR astigmatism, shifts (2.09 +/- 0.22D, 1.93 +/- 0.13D, respectively) after the first week were much smaller than those of preoperative with-the-rule astigmatism. Thereafter, degrees of oblique and AR astigmatism increased and remained higher even six months after surgery. The induction and spontaneous regression of postoperative AR astigmatism was similar to that of oblique astigmatism. Compression of the lids on the eye may be a more important factor than previously considered.