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Long-term astigmatic changes after clear corneal cataract surgery

K Müller-Jensen1, B Barlinn

  • 1Städtisches Klinikum, Augenklinik, Karlsruhe, Germany.

Journal of Cataract and Refractive Surgery
|April 1, 1997
PubMed
Summary

Clear corneal cataract surgery incisions impact long-term astigmatism. Lateral incisions showed a significant decrease in astigmatism, while 12 o'clock incisions had an insignificant increase after two years.

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Corneal Physiology

Background:

  • Cataract surgery is a common procedure.
  • Astigmatism can be induced or altered by surgical incisions.
  • Long-term astigmatic changes after clear corneal cataract surgery require evaluation.

Purpose of the Study:

  • To assess long-term astigmatic changes after clear corneal cataract surgery.
  • To compare astigmatic outcomes between superior (12 o'clock) and lateral corneal incisions.
  • To evaluate the impact of incision placement on surgically induced astigmatism and absolute astigmatism.

Main Methods:

  • Prospective evaluation of 100 patients undergoing cataract surgery with either superior or lateral clear corneal self-assessing incisions.
  • Implantation of a 5.0 mm poly(methyl methacrylate) intraocular lens.

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  • Measurement of surgically induced astigmatism (IA) and absolute astigmatism (AA) using keratometry and corneal topography at 1 week, 1 year, and 2 years postoperatively.
  • Statistical analysis using the Wilcoxon signed-rank test.

    • Main Results:

    • Eyes with a 12 o'clock incision showed a mean IA of 1.53 +/- 0.95 D after 2 years.
    • Eyes with lateral incisions demonstrated a mean IA of 0.64 +/- 0.50 D after 2 years.
    • A statistically significant difference in astigmatism was observed between the groups after 2 years, with lateral incisions leading to a decrease.

    Conclusions:

    • Lateral clear corneal incisions in cataract surgery are associated with a statistically significant decrease in long-term astigmatism.
    • Superior (12 o'clock) incisions resulted in a statistically insignificant increase in astigmatism at 2 years.
    • Routine use of clear corneal incisions, particularly lateral ones, is recommended for managing astigmatism during cataract surgery.