J Korean Ophthalmol Soc > Volume 57(1); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(1):25-35.
DOI: https://doi.org/10.3341/jkos.2016.57.1.25    Published online January 15, 2016.
Analysis of Changes in Anterior, Posterior and Total Corneal Astigmatism after On-Axis Cataract Surgery.
Kee Il Lee, Yu Li Park, Hyun Seung Kim
Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea. Sara514@catholic.ac.kr
백내장 수술 후 각막 전면, 후면 및 전체 난시 변화
가톨릭대학교 의과대학 안과 및 시과학교실
To assess the changes in anterior, posterior, and total corneal astigmatism after cataract surgery with on-axis clear corneal incision cataract surgery. METHODS: This study included 48 eyes (24 eyes with 'with-the-rule [WTR]' and 24 eyes with 'against-the-rule [ATR]') that underwent phacoemulsification and intraocular lens insertion through on-axis clear corneal incision. The ATR group with vertically steep axis of posterior corneal astigmatism was divided into subgroups 1 and 2 for the opposite axis. Autorefraction, uncorrected and best-corrected visual acuities were measured. Corneal astigmatism (anterior, posterior and total) was measured using Pentacam(R) preoperatively and 1 week, 1 month, and 2 months postoperatively. RESULTS: Multivariate linear regression analysis of preoperative data showed positive correlations among anterior, posterior and total astigmatism. Anterior corneal astigmatism showed a significant decrease in both WTR and ATR groups in all measured points (all p < 0.05). Posterior corneal astigmatism showed no statistical difference in the WTR group and ATR subgroup 2 (p > 0.05) and significant decrease in the ATR subgroup 1 (p < 0.05) at 2 months postoperatively. Total corneal astigmatism showed significant decrease 2 months after surgery in the WTR group and ATR subgroup 1 (all p < 0.05), but not in the ATR subgroup 2 (p > 0.05). According to correlation analysis based on trend line equations, 1.7 diopters of anterior astigmatism could expect 0.3 diopters of posterior astigmatism and 0.5 diopters of total astigmatism for the WTR group and 0.4 diopters of anterior astigmatism could expect 0.2 diopters of posterior astigmatism and 0.4 diopters of total astigmatism for the ATR group. CONCLUSIONS: Considering the majority of cataract patients have vertically steep posterior corneal astigmatism, temporal incision for ATR patients is generally effective. Moreover, for patients with WTR astigmatism of more than 1.7 diopters or ATR astigmatism greater than 0.8 diopters, additional preoperative correction based on posterior astigmatism is needed for more precise prediction of postoperative total corneal astigmatism.
Key Words: Against-the-rule (ATR);On-axis incision;Posterior corneal astigmatism;With-the-rule (WTR)

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