Abstract
Background
Corneal astigmatism is a well-documented finding after cataract surgery. Postoperative astigmatism is of greater importance in children than in adults, because of its adverse effect on vision development and the risk of amblyopia. The purpose of this study was to evaluate refractive outcomes in eyes- which had high early postoperative astigmatism after congenital cataract surgery.
Methods
We retrospectively reviewed the charts of 74 children (112 eyes), who underwent congenital cataract extraction with intraocular lens implantation, using limbal incision, scleral tunnel, or clear corneal incision. Thirty-two eyes of 28 children, aged 2 months to 11 years, had astigmatism of 3.0 diopters (D) or more when assessed 1 week after surgery. Changes in cylinder vector, spherical equivalent (SEQ) and defocus equivalent (DEQ) between 1 week and 5 months postoperatively were calculated for each group.
Results
Mean SEQ and DEQ were 0.7±3.5 D and 5.1±2.8 D, respectively, at 1 week postoperatively- and −0.2±3.4 D and 3.1±2.3 D, respectively, at 5 months postoperatively in the three groups. DEQ levels showed a significant reduction during the 5-month follow-up period (P<0.001). The mean astigmatism vector was 2.9±3.3 D×93° in all the three groups 1 week postoperatively- and 0.2±1.1 D×153° at 5 months after surgery. A significant change during 5-month follow-up in cylinder vector (P<0.02) and SEQ (P=0.01) was found after operations using scleral tunnel technique.
Conclusion
Children- who underwent congenital cataract surgery by different surgical techniques showed a significant spontaneous reduction in DEQ values. A significant change in cylinder vector and SEQ was found after operations using scleral tunnel technique.
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References
Barequet IS, Yu E, Vitale S, Cassard S, Azar DT, Stark WJ (2004) Astigmatism outcomes after horizontal temporal versus nasal clear corneal incision cataract surgery. J Cataract Refract Surg 30:418–423
Brown SM, Hodges MR, Corona J (2001) Relaxation of postoperative astigmatism after lens implantation through a 6.25 mm scleral wound in children. J Cataract Refract Surg 27:2012–2016
Fulton AB, Dobson V, Salem D et al (1980) Cycloplegic refractions in infants and young children. Am J Ophthalmol 90:239–247
Holladay JT, Moran JR, Kezirian GM (2001) Analysis of aggregate surgically induced refractive change, prediction error, and intraocular astigmatism. J Cataract Refract Surg 27:61–79
Jaffe NS (1981) Cataract surgery and its complications, 3rd edn. CV Mosby, St Louis, pp 92–110
Kronish JW, Forster RK (1987) Control of corneal astigmatism following cataract extraction by selective suture cutting. Arch Ophthalmol 105:1650–1655
Richards SC, Brodstein RS, Richards WL et al (1988) Long-term course of surgically induced astigmatism. J Cataract Refract Surg 14:270–276
Sekundo W, Böker T, Fimmers R (2000) Induced corneal astigmatism using an asymmetric corneoscleral tunnel and a large-optic intraocular lens. J Cataract Refract Surg 26:79–82
Stanford MR, Fenech T, Hunter PA (1993) Timing of removal of sutures in control of post-operative astigmatism. Eye 7:143–147
Spierer A, Shelah M (1999) Changes in astigmatism after cataract extraction and intraocular lens implantation in children. Eye 13:360–362
Talamo JH, Stark WJ, Gottsch JD et al (1991) Natural history of corneal astigmatism after cataract surgery. J Cataract Refract Surg 17:313−318
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This study was supported by a grant from the Sackler Faculty of Medicine, Tel-Aviv University, Israel.
The authors have no relevant financial interest in this article.
The authors have full control of all primary data and they agree to allow Graefe’s Archives for Clinical and Experimental Ophthalmology to review their data if requested.
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Bar-Sela, S.M., Barequet, I.S. & Spierer, A. Vector analysis of high early postoperative astigmatism after congenital cataract surgery. Graefe's Arch Clin Exp Ophthalmol 243, 881–885 (2005). https://doi.org/10.1007/s00417-005-1153-6
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DOI: https://doi.org/10.1007/s00417-005-1153-6