Nonkeratometric control of postoperative astigmatism

A scleral pocket incision technique with continuous suture closure was used in a series of 40 patients undergoing phacoemulsification with posterior chamber lens implantation to determine the change in astigmatic error induced by surgery. Intraoperative keratometry was not used and no attempt to estimate the induced cylinder at the time of surgery was made. Keratometric analysis of postoperative astigmatism in the present study indicated that shortly after surgery there was an induced with-the-rule shift that gradually abated to a minimal against-the-rule change after the wound was fully healed, regardless of how tight the wound was closed at the time of surgery. It appears that intraoperative keratometry would have had no bearing on the final astigmatic outcome.