Corneal astigmatism independent of patient age at surgery
Optimal planning for correction of pre-existing corneal astigmatism at the time of cataract surgery should take into account an age-related, against-the-rule (ATR) shift.
Fukuoka, Japan-Optimal planning for correction of pre-existing corneal astigmatism at the time of cataract surgery should take into account an age-related, against-the-rule (ATR) shift.
Now, results from a retrospective study conducted by Ken Hayashi, MD, and colleagues shows that the magnitude of the shift is similar regardless of patient age at the time of surgery and compared with eyes that do not undergo cataract surgery [Hayashi K, et al. Am J Ophthalmol. 2015;160(1):171-178]
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“Based on these findings, surgeons can determine what amount of with-the-rule (WTR) astigmatism should remain or be induced at the time of cataract surgery for each patient,” said Dr. Hayashi, director, Hayashi Eye Hospital, Fukuoka, Japan, “based on his or her age using the astigmatism-correcting method, including the toric IOL, steepest meridian incision, or limbal-relaxing incision.”
In previous work, Dr. Hayashi and colleagues showed that corneal astigmatism alters from WTR astigmatism to ATR astigmatism at 60 years of age, whether or not there has been cataract surgery [Hayashi K, et al. Am J Ophthalmol. 2011;151(5):858-865].
Previous data
Analyzing data from 153 eyes that underwent phacoemulsification, they found that corneal astigmatism showed an ATR shift of about 0.35 D within 10 years after stabilization of the surgically induced astigmatism (SIA) due to small-incision horizontal cataract surgery. A similar, long-term change in corneal astigmatism occurred in a group of 153 age-matched, nonsurgical control eyes.
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The present study analyzed data from 437 eyes of 437 patients that had at least 11 years of follow-up after phacoemulsification, with a 4.1-mm sutureless, horizontal scleral incision, and a control group of 600 unoperated eyes. Eyes in both groups were stratified by patient age into 4 subgroups: ≤60 years, 61-65 years, 66-70 years, and ≥71 years.
Courtesy of Ken Hayashi, MD
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