Corneal Astigmatic Change in Corneal Topography After Upper Eyelid Surgery

PURPOSE: The study was conducted to determine if there is a corneal astigmatic changes after upper eyelid surgery by using corneal topography and if these changes are the reason why some patients note a decrease in visual acuity. METHODS: Twenty four eyes of 12 patients with dermatochalasis who had undergone upper eyelid blepharoplasty, and 24 eyes of 12 patients who had undergone aesthetic double fold formation were included. We performed corneal topography during the postoperative 3 months and also evaluated the corneal refractive index change on thirteen points of the central cornea, which were located in the center of the corneal apex and apart from it by 1.5, 2.5, 3.5 mm along each axis corresponding to the 0 degrees, 90 degrees, 180 degrees, 270 degrees respectively. RESULTS: Corneal topography demonstrated increase in with-the-rule astigmatism by 38, 33, and 12% for dermatochalasis patients at 1week, 1month, and 3months after surgery, and by 25%, 17%, and 13% for double fold patients. However the increase in with-the-rule astigmatism seemed to be temporary, showing gradual regression. The refractive index change of thirteen points of central cornea was not significant except a few eyes with astigmatic changes greater than 1D until 1 month after surgery. There was alsoincreased astigmatism after surgery in vector-corrected analysis. CONCLUSIONS: There was a tendency of increase in with-the-rule astigmatism and those changes were temporary and regressed gradually. No patient showed significant refractive index change on the 13 points of central cornea but some showed changes greater than 1 D in the early postoperative period, causing visually significant astigmatic changes temporarily.

Induced Astigmatism after Rabbit Cataract Surgery Using Tissue Adhesive

In order to compare the amount of surgically induced astigmatism among sutureless group(Group 1),10-0 nylone suture group(Group 2),and using tissue adhesive group(Group 3),we analysed a series of rabbit cataract surgery cases in these three groups. We performed cataract surgery on 30 eyes of 15 rabbits by Irrigation and aspiration technique. After cataract surgery,10 eyes by sutureless technique,10 eyes were closed by conventional 10-0 nylon suture technique, and 10 eyes by tissue adhesive(Beriplast) technique.We collected keratometric data before and after surgery(At 1,2,4,8 weeks).In postoperative astigmatic change,three groups had the distinct features in the evolution for postoperative astigmatism.The group 1 showed early against-the-rule(ATR)astigmatism,which advanced ATR and showed about 0.5D astigmatic change at 8 weeks.The group 2 showed early with-the-rule(WTR)astigmatism about 1.13D,which advanced toward ATR from 1week.The group 3 showed little ATR about 0.2D,which was minimal change in astigmatism.At 8 weeks after operation,there was no signifi-cant difference in the astigmatic change among the three groups(P>0.05), which were no complications observed. In this study,the tissue adhesive(Beriplast)seem to be a simple,effective and less induced astigmatic changing corneoscleral suture technique than other suture techniques

Changes of Astigmatism and Visual Rehabilitation Following Small Incision Cataract Surgery and Implantation with Silicone or PMMA Intraocular Lenses

We analyzed early postoperative astigmatic changes, visual rehabilitation and complications with silicone intraocular lenses implanted through 3.2mm scleral pocket incision (group I. 68 eyes) and PMMA intraocular lenses implanted through 5.5mm scleral pocket incision(group 2. 103 eyes). Surgically induced astigmatism in group 1 was -0.17D at two days, -0.12D at one week, and -0.51D at two months. In group 2, it was -0.36D at two days, -0.46D at one week, and -0.72D at two months. There was a statistically significant difference between the two groups at 2 days and 1 week (p0.05). 0.5 or better uncorrected visual acuity in group I was 74% at 2 weeks, 87% at 2 months while in group 2, it was 69% at 2 weeks, and 77% at 2 months. Postoperative complication in group I were two cases of IOL decentration(2.9%), two cases of anterior capsule contraction (2.9%), three cases of anterior chamber inflammation (4.4%), and two cases of posterior capsule opacity (2.9%). In group two, it were one case of hyphema (1%), one case of wound dehiscence (1%) , one case of anterior chamber inflammation (1%), and seven cases of posterior capsule opacity (6.8%). Our results indicate the 3.2mm scleral tunnel incision (group 1) was associated with a lower surgically induce astigmatism at 2 days and 1 week, and 8 faster visual rehabilitation than 5.5mm scleral tunnel incision (group 2), but anterior chamber inflainmation, anterior capsule contraction and IOL decentrations were more frequently developed in group 1.

Comparision of Surgically Induced Astigmatism between Superior and Temporal Scleral Incision in Planned Extracapsular Cataract Extraction

Astigmatic change in planned extracapsular cataract extraction (P-ECCE) using temporal scleral incision (n=25 eyes) was compared for 2 months with that using superior scleral incision(n=19 eyes), retrospectively. The astigmatic change was analyzed using Naeser`s polar value. Surgically induced astigmatism induced by temporal scleral incision was 0.96+/-1.38D of with the rule(WTR), 2.35+/-1.36D (WTR), and 2.45+/-1.24(WTR) at 3 days, 2 weeks, and 2 months, respectively. In contrast, that induced by superior scleral incision was 2.29+/-2.30D(WTR), 0.76+/-2.39(WTR)and -0.95+/-1.88D of against the rule(ATR) at 3 days, 2 weeks, and 2 months, respectively. In another words, temporal scleral incision in P-ECCE induced WTR astigmatism as early as postoperative 3 days that incerased by 2 weeks and stabilized after 2 weeks, whereas superior scleral incision in P-ECCE induced a prominent WTR astigmatism as early as postoperative 3 days, that was converted to ATR astigmatism from 1 month and increased the change by 2 months. With this result, it was found that most cataract patients existing ATR astigmatism would be candidates for temporal incision in P-ECCE.