Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea.
Am J Ophthalmol. 2013 Dec;156(6):1112-1119.e2. doi: 10.1016/j.ajo.2013.06.039. Epub 2013 Aug 21.
To evaluate the axis difference between corneal and internal astigmatism in patients with cataract, because if the axis of corneal astigmatism is opposite to the axis of internal astigmatism, the amount of refractive astigmatism will increase after cataract surgery owing to disappearance of the neutralizing effect of the crystalline lens on corneal astigmatism.
Retrospective cross-sectional study.
One hundred eighty patients (180 eyes) who underwent cataract surgery were enrolled. Preoperative refractive, corneal, and internal astigmatism were measured using a wavefront analyzer and retrospectively analyzed. On-axis was defined as an axis difference between corneal and internal astigmatism of 180 ± 10 degrees. Opposite-axis was defined as an axis difference between corneal and internal astigmatism of 90 ± 10 degrees. The remaining cases were defined as oblique-axis.
Corneal and internal astigmatic vectors showed a tendency to have the opposite direction. An on-axis difference was seen in 10.0% of patients (18 eyes), oblique-axis in 69.4% of patients (125 eyes), and opposite-axis in 20.6% of patients (37 eyes). Of all eyes, 10.0% had an opposite-axis difference with more than 1.00 diopter (D) of both corneal and internal astigmatism. The percentage of eyes with an opposite-axis difference between corneal and internal astigmatism had a tendency to increase as corneal and internal astigmatism increased (P = .030 and P = .003, respectively).
A total of 10.0% of all eyes with cataract had an opposite-axis difference with more than 1.00 D of both corneal and internal astigmatism. In these cases, surgical techniques to reduce corneal astigmatism, such as a toric intraocular lens, should be recommended to increase patient satisfaction.
评估白内障患者角膜和眼内散光的轴向差异，因为如果角膜散光的轴向与眼内散光的轴向相反，那么在白内障手术后，由于晶状体对角膜散光的中和作用消失，屈光性散光的量将会增加。
回顾性横断面研究。
纳入了 180 例（180 只眼）接受白内障手术的患者。使用波前像差仪测量术前屈光、角膜和眼内散光，并进行回顾性分析。将眼轴定义为角膜和眼内散光的轴差异为 180 ± 10 度。将反轴定义为角膜和眼内散光的轴差异为 90 ± 10 度。其余病例定义为斜轴。
角膜和眼内散光矢量呈相反方向的趋势。10.0%（18 只眼）的患者存在眼轴差异，69.4%（125 只眼）的患者存在斜轴差异，20.6%（37 只眼）的患者存在反轴差异。在所有眼中，有 10.0%的眼存在角膜和眼内散光的反轴差异，且两者相差超过 1.00 屈光度（D）。随着角膜和眼内散光的增加，存在角膜和眼内散光反轴差异的眼的比例呈增加趋势（P =.030 和 P =.003）。
总共 10.0%的白内障患者存在角膜和眼内散光相差超过 1.00 D 的反轴差异。在这些情况下，应推荐使用角膜散光矫正术，如散光型人工晶状体，以提高患者满意度。
