Postoperative Astigmatic Outcomes Based on the Haptic Axis of Intraocular Lenses Inserted in Cataract Surgery

PURPOSE: This study was conducted to compare post-operative astigmatic outcomes of two groups, with-the-rule (WTR) and against-the-rule (ATR) astigmatism patients, according to the haptic axis of intraocular lenses (IOLs) inserted in cataract surgery. METHODS: Seventy-two eyes with WTR astigmatism and 79 eyes with ATR astigmatism had cataract surgery through a clear corneal temporal incision. These two groups of eyes were then each divided into 2 groups based on whether the haptic axis of the inserted IOL was at 180degrees or 90degrees. For ATR patients, the outcomes were analyzed according to the three types of IOLs. RESULTS: There was no difference in corneal astigmatism, but WTR patients with a 180degrees haptic axis of the inserted IOL and ATR patients with a 90degrees hepatic axis of the inserted IOL had a significant decrease in postoperative refractive astigmatism (p < 0.05). The changes in ATR astigmatism according to the IOL type were more effective in single-piece acrylic IOLs than in the three-piece polymethylmethacrylate haptic IOL group. CONCLUSIONS: Insertion of the IOL at the 180degrees haptic axis in WTR patients and at 90degrees in ATR patients during cataract surgery may have an effect in reducing pre-existing astigmatism. This observed effect was not consistent among the different types of IOLs.

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

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 180degrees or 90degrees), 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 180degrees 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 90degrees. In particular, the group with the sutured temporal incision and with an inserted intraocular lens axis at 180degrees 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 180degrees can reduce astigmatism and minimize the effect of surgically-induced astigmatism.