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Long-term changes in manifest refraction subsequent to cataract surgery
Ken Hayashi1, Motoaki Yoshida, Shin-Ichi Manabe
1From the Hayashi Eye Hospital, Fukuoka, Japan.
Journal of Cataract and Refractive Surgery
|August 9, 2021
Summary
Cataract surgery patients showed stable spherical power but a significant shift towards against-the-rule astigmatism over 7 years. Non-surgically treated eyes experienced both spherical and astigmatic changes, with surgery mitigating refractive shifts.
Area of Science:
- Ophthalmology
- Refractive Surgery
- Long-term Outcomes
Background:
- Cataract surgery aims to restore vision by removing the clouded lens.
- Understanding long-term refractive stability after surgery is crucial for patient outcomes.
- Surgically induced changes (SICs) can influence refractive error progression.
Purpose of the Study:
- To investigate long-term refractive changes after cataract surgery.
- To compare refractive stability in pseudophakic (lens-implanted) and phakic (natural lens) eyes over 7 years post-stabilization of SICs.
Main Methods:
- A case-control study involving 300 eyes post-phacoemulsification and 300 age/sex-matched controls.
- Manifest refraction measured at SIC stabilization (baseline) and ≥7 years postbaseline.
- Power vector analysis used to assess spherical (M), vertical/horizontal (J0), and oblique (J45) astigmatism components.
Main Results:
- Pseudophakic eyes showed stable spherical power (M) but a significant increase in against-the-rule (ATR) astigmatism (J0) over 7 years.
- Phakic control eyes exhibited significant myopic shift (increased M) and ATR astigmatism (decreased J0).
- The change in spherical power was significantly smaller in the surgery group compared to controls.
Conclusions:
- Refractive astigmatism significantly shifts towards ATR in pseudophakic eyes long-term after cataract surgery.
- Phakic eyes demonstrate hyperopic and ATR shifts, with comparable astigmatic changes to pseudophakic eyes over the long term.
- Cataract surgery appears to stabilize spherical refractive outcomes while inducing an ATR astigmatic shift over 7 years.
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