The Changes of With-the-rule Astigmatism After Clear Corneal Temporal Incision Cataract Surgery

Hae Young Park; Hyun Seung Kim

doi:10.3341/jkos.2008.49.3.433

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Park and Kim: The Changes of With-the-rule Astigmatism After Clear Corneal Temporal Incision Cataract Surgery

Original Article

J Korean Ophthalmol Soc 2008;49(3):433-441.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.3.433

The Changes of With-the-rule Astigmatism After Clear Corneal Temporal Incision Cataract Surgery

Hae Young Park, M.D., Hyun Seung Kim, M.D., Ph.D.

DeSpartment of Ophthalmology and Visual Science, St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Hyun Seung Kim, M.D., Ph.D. Department of Ophthalmology and Visual science, St. Mary's Hospital, The Catholic University of Korea #62 Yeoeuido-dong, Yeongdeungpo-gu, Seoul 150-713, Korea Tel: 82-2-3779-1243, Fax: 82-2-761-6869, E-mail: sara514@catholic.ac.kr

Received 14 August 2007 Accepted 27 November 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The effect of suture presence or position of intraocular lens was evaluated on the astigmatic changes in cataract patients suffering from with-the-rule astigmatism who underwent temporal clear corneal incision cataract surgeries.

Methods

According to the presence or absence of suture and the lens position (either 180˚ or 90˚), 49 eyes of 47 patients were divided into four groups. Astigmatism was determined using an autorefractor and by topography before surgery, and at one day, one week, one month, and two months after surgery.

Results

The suture group showed significant reduction in astigmatism at postoperative day 1 and week 1 by autorefractor and topography compared with the non-suture group. The group with intraocular lens insertion axis at 180˚ did not show significant reduction of astigmatism by autorefractor evaluation. Astigmatism determination by topography in this group was 1.00±0.73D, 1.01±0.77D and 1.01±0.81D at postoperative week 1, month 1, and month 2, respectively, and this showed significant reduction of astigmatism compared with preoperative astigmatism (1.32±1.17D) and group with intraocular lens insertion axis at 90˚. In particular, the group with the sutured temporal incision and with an inserted intraocular lens axis at 180˚ showed significant reduction of astigmatism by autorefraction.

Conclusions

When performing cataract surgery in with-the-rule astigmatism patients, suturing the temporal incision and inserting the intraocular lens axis at 180˚ can reduce astigmatism and minimize the effect of surgically-induced astigmatism.

Keywords: Cataract, Clear corneal temporal incision, Intraocular lens, With-the-rule astigmatism

References

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Figure 1.

Sheme of intraocular lens insertion axis of a patient's right eye. Imaginary line of haptic-optic-haptic lying horizontally is defined to be inserted at 180° axis (Left) and vertically is defined to be at 90° axis (Right).

Figure 2.

The changes of mean astigmatism in suture and no suture groups by topography measurement (A), autorefractor measurement (B). (* P<0.05)

Figure 3.

The changes of mean astigmatism in 180° axis IOL and 90° axis IOL group by topography measurement (A), autorefractor measurement (B). (* P<0.05)

Figure 4.

The changes of mean astigmatism in each groups by autorefractor measurement. (* P<0.05) Group I=suture+Haptic 180° group. Group II=suture+Haptic 90° group. Group III=no suture+Haptic 180° group. Group IV=no suture+Haptic 90° group.

Figure 5.

The changes of mean astigmatism in each group by keratometric measurement. (* P<0.05) Group I=suture+Haptic 180° group. Group II=suture+Haptic 90° group. Group III=no suture+Haptic 180° group. Group IV=no suture+Haptic 90° group.

Table 1.

Dermographics and preoperative astigmatism of each group

	Group I	Group II	Group III	Group IV	P-value
Eye	12	11	12	14
Age	59.36±11.79	45.60±16.86	55.67±12.32	58.57±13.59	0.319
Gender (F:M)	7:5	5:6	8:4	6:8
Autorefractor: Cylinder (D)	1.70±1.38	1.43±0.76	0.96±0.91	1.53±1.36	0.461
Topography: Sim K's (D)	1.67±0.52	1.02±0.62	0.88±0.54	1.48±0.26	0.110

Group I=suture+Haptic 180° group; Group II=suture+Haptic 90° group; Group III=no suture+Haptic 180° group; Group IV=no suture+Haptic 90° group.

Table 2.

The change of mean astigmatism in suture and no suture groups by autorefractor and topography measurement (Diopter)

	Suture Group (Group I+II)	No suture Group (Group III+IV)	P-value
Autorefractor
Preoperative	1.54±1.10	1.27±1.13	0.971
Postoperative 1 day	1.25±0.68	1.40±1.30	0.016
Postoperative 1 week	1.09±0.69	1.23±1.09	0.026
Postoperative 1 month	1.20±0.88	1.29±1.06	0.808
Postoperative 2 months	1.20±0.86	1.33±1.02	0.061
Topography
Preoperative	1.55±1.15	1.21±0.79	0.466
Postoperative 1 week	1.35±0.89	1.53±1.07	0.036
Postoperative 1 month	1.52±0.93	1.51±1.08	0.585
Postoperative 2 months	1.44±0.90	1.49±1.11	0.446

Group I=suture+Haptic 180° group; Group II=suture+Haptic 90° group; Group III=no suture+Haptic 180° group; Group IV=no suture+Haptic 90° group.

Table 3.

The change of mean astigmatism in IOL insertion axis groups by autorefractor and topography measurement (Diopter)

	Haptic 180° Group (Group I+III)	Haptic 90° Group (Group II+IV)	P-value
Autorefractor
Preoperative	1.32±1.17	1.46±1.09	0.971
Postoperative 1 day	1.28±1.00	1.39±1.15	0.621
Postoperative 1 week	1.00±0.73	1.34±1.09	0.051
Postoperative 1 month	1.01±0.77	1.49±1.11	0.050
Postoperative 2 months	1.01±0.81	1.53±1.30	0.048
Topography
Preoperative	1.40±1.14	1.30±0.79	0.466
Postoperative 1 week	1.34±0.88	1.56±1.11	0.537
Postoperative 1 month	1.42±0.95	1.61±1.07	0.585
Postoperative 2 months	1.29±0.97	1.65±1.05	0.446

Group I=suture+Haptic 180° group; Group II=suture+Haptic 90° group; Group III=no suture+Haptic 180° group; Group IV=no suture+Haptic 90° group.

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