Long-term changes in manifest refraction subsequent to cataract surgery

摘要

Purpose: To examine the long-term refractive changes after stabilization of surgically induced changes (SICs) subsequent to cataract surgery.Setting: Private hospital. Design: Case-control study.Methods: Manifest refraction of 300 eyes of 300 patients who underwent phacoemulsification and 300 eyes of 300 age-matched and sex-matched patients without surgery was examined the day on which SICs stabilized (baseline) and >=7 years postbaseline using an autorefractometer. Refraction was divided into 3 components: spherical power (M), vertical/horizontal astigmatism (Jo), and oblique astigmatism (J45) using power vector analysis, and the components were compared between the 2 timepoints and between groups.Results: Data of All 600 eyes were collected. In the surgery group, the mean M and J45 did not change significantly between baseline and >7 years postbaseline, but the Jo significantly decreased between the 2 timepoints (P < .001), indicating an against-the-rule (ATR) shift. In the nonsurgery group, the mean M significantly increased and Jo significantly decreased between the timepoints (P < .001), whereas J45 did not change significantly. The mean change in M between the 2 timepoints was significantly smaller in the surgery group (P < .001), whereas the changes in Jo and J45 did not differ significantly between the timepoints.Conclusions: Spherical power did not change and refractive astigmatism significantly changed toward ATR astigmatism during the more than 7-year follow-up after stabilization of SICs in pseudophakic eyes, whereas hyperopic and ATR shifts occurred in phakic eyes, and the astigmatic changes were comparable between pseudophakic and phakic eyes.