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KMID : 0213520090230040240
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Korean Journal of Ophthalmology
2009 Volume.23 No. 4 p.240 ~ p.248
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Perioperative Modulating Factors on Astigmatism in Sutured Cataract Surgery
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Cho Yang-Kyeung
Kim Man-Soo
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Abstract
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Purpose: To evaluate the factors that affect postoperative astigmatism and post-suture removal astigmatism, and to evaluate the risk factors associated with astigmatism axis shift.
Methods: We performed a retrospective chart review of 130 eyes that had undergone uneventful phacoemulsification cataract surgery. Preoperative astigmatism was divided into four groups (Groups I, II, III, and IV) according to the differences between the axis of preoperative astigmatism (flattest axis) and the incision axis (105 degrees). We analyzed the magnitude and axis of the induced astigmatism after the operation and after suture removal in each group. We also analyzed the factors which affected the postoperative astigmatism and post-suture removal astigmatism in each sub-group of Groups I, II, III, and IV, excluding postoperative or post-suture removal axis shift (specifically, Group IWAS, IIWAS, IIIWAS, and IVWAS). We identified the variables associated with the prevalence of postoperative astigmatism axis shift and those associated with the prevalence of post-suture removal axis shift.
Results: An increase in the magnitude of postoperative astigmatism was associated with an increase in the preoperative magnitude of astigmatism in Groups IWAS, IIWAS, and IIIWAS (p<0.05), and with an increase in the corneal tunnel length in Group IWAS. A decrease in the magnitude of postoperative astigmatism was associated with an increase in the corneal tunnel length in Groups IIIWAS and IVWAS (p<0.05). An increase in the magnitude of post?suture removal astigmatism was associated with an increase in the magnitude of postoperative astigmatism in Groups IWAS and IVWAS (p<0.05), and with late suture removal in Group IVWAS (p<0.05). A decrease in the magnitude of post?suture removal astigmatism was associated with late suture removal in Groups IWAS and IIWAS. A logistic regression analysis showed that the prevalence of post? suture removal astigmatism axis shift was associated with increased corneal tunnel length, decreased magnitude of postoperative astigmatism, and early suture removal.
Conclusions: In order to reduce postoperative and post?suture removal astigmatism, we recommend a short corneal tunnel length and late suture removal in patients with Group IWAS characteristics, late suture removal in Group IIWAS? like patients, long corneal tunnel length in Group IIIWAS?like patients, and long corneal tunnel length and early suture removal in patients with characteristics of Group IVWAS.
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KEYWORD
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Astigmatism, Sutured cataract surgery, Tunnel length
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