Effect of small-incision sutureless cataract surgery on the natural course of astigmatism over 10 to 20 years. Issue 10 (October 2022)

• Record Type: Journal Article
• Authors: Inoue, Yasushi; Takehara, Hiroyasu; Sugita, Toru; Kaneko, Tsutomu; Miyata, Kazunori; Honbou, Masato; Miyoshi, Teruyuki; Fujie, Shuhei; Oshika, Tetsuro
• Is Part Of: Journal of cataract and refractive surgery. Volume 48:Issue 10(2022)
• Page Start: 1121
• Page End: 1125
• Publication Date: 2022-10
• Subjects: 617.7
• DOI: 10.1097/j.jcrs.0000000000000941
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : After small-incision cataract surgery, against-the-rule (ATR) astigmatic changes continue over 20 years, regardless of the type of preoperative astigmatism: with-the-rule, ATR, and oblique astigmatism. Abstract : Purpose: To retrospectively assess astigmatic changes over 10 years and 20 years after small-incision cataract surgery. Setting: 5 ophthalmic surgical sites in Japan. Design: Retrospective case series. Methods: Data were collected from patients who had undergone phacoemulsification and implantation of an intraocular lens through a 2.2 to 2.4 mm incision. Preoperative corneal and postoperative manifest astigmatism were converted to power vector notations: horizontal/vertical (J0 ) and oblique (J45 ) astigmatism components. Results: 422 eyes of 422 patients were followed for 10 years, and data preoperatively and at 1 month and at 1 year, 3 years, 5 years, 8 years, and 10 years postoperatively were analyzed. The mean J0 decreased significantly ( P < .001, repeated measures analysis of variance) with an against-the-rule (ATR) shift of 0.363 ± 0.433 diopter (D) over 10 years, but the mean J45 did not change significantly ( P = .150). Double-angle plot analyses also showed similar ATR shifts in all astigmatism groups. In the subgroup analysis conducted in 34 patients who were followed for 20 years, J0 declined significantly ( P < .001) by 0.649 ± 0.576 D, whereas J45 did not ( P = .516). The postoperative changes in J0 and J45 were not significantly different between eyes with preoperative with-the-rule, ATR, or oblique astigmatism. Conclusions: Postoperative astigmatism continued to shift toward ATR during the follow-up period of 20 years after small-incision cataract surgery, which seems to reflect the natural course of corneal astigmatic changes that commonly occur with aging. ATR astigmatic shifts were similar in both pattern and magnitude regardless of the type of preoperative astigmatism.