From the Inoue Eye Clinic, Okayama, Japan (Inoue, Takehara); Sugita Eye Clinic, Tokyo, Japan (Sugita, Kaneko); Miyata Eye Hospital, Miyazaki, Japan (Miyata, Honbou); Miyoshi Eye Clinic, Hiroshima, Japan (Miyoshi, Fujie); Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan (Oshika).
J Cataract Refract Surg. 2022 Oct 1;48(10):1121-1125. doi: 10.1097/j.jcrs.0000000000000941.
To retrospectively assess astigmatic changes over 10 years and 20 years after small-incision cataract surgery.
5 ophthalmic surgical sites in Japan.
Retrospective case series.
Data were collected from patients who had undergone phacoemulsification and implantation of an intraocular lens through a 2.2 to 2.4 mm incision. Preoperative corneal and postoperative manifest astigmatism were converted to power vector notations: horizontal/vertical (J 0 ) and oblique (J 45 ) astigmatism components.
422 eyes of 422 patients were followed for 10 years, and data preoperatively and at 1 month and at 1 year, 3 years, 5 years, 8 years, and 10 years postoperatively were analyzed. The mean J 0 decreased significantly ( P < .001, repeated measures analysis of variance) with an against-the-rule (ATR) shift of 0.363 ± 0.433 diopter (D) over 10 years, but the mean J 45 did not change significantly ( P = .150). Double-angle plot analyses also showed similar ATR shifts in all astigmatism groups. In the subgroup analysis conducted in 34 patients who were followed for 20 years, J 0 declined significantly ( P < .001) by 0.649 ± 0.576 D, whereas J 45 did not ( P = .516). The postoperative changes in J 0 and J 45 were not significantly different between eyes with preoperative with-the-rule, ATR, or oblique astigmatism.
Postoperative astigmatism continued to shift toward ATR during the follow-up period of 20 years after small-incision cataract surgery, which seems to reflect the natural course of corneal astigmatic changes that commonly occur with aging. ATR astigmatic shifts were similar in both pattern and magnitude regardless of the type of preoperative astigmatism.
回顾性评估小切口白内障手术后 10 年和 20 年的散光变化。
日本 5 个眼科手术部位。
回顾性病例系列。
数据来自接受超声乳化白内障吸除术和通过 2.2 至 2.4 毫米切口植入人工晶状体的患者。术前角膜和术后显性散光转换为力向量符号：水平/垂直（J0）和斜向（J45）散光分量。
422 例 422 只眼随访 10 年，分析术前及术后 1 个月、1 年、3 年、5 年、8 年和 10 年的数据。J0 平均值显著降低（P <.001，重复测量方差分析），10 年内出现逆规散光（ATR）移位 0.363 ± 0.433 屈光度（D），但 J45 平均值无显著变化（P =.150）。双角度图分析也显示所有散光组均有类似的 ATR 移位。在 34 例随访 20 年的患者亚组分析中，J0 显著下降（P <.001），下降 0.649 ± 0.576 D，而 J45 无明显变化（P =.516）。术前规则性、ATR 或斜向散光的眼术后 J0 和 J45 的变化无显著差异。
小切口白内障手术后 20 年的随访期间，术后散光继续向 ATR 移位，这似乎反映了角膜散光随年龄增长而发生的自然变化过程。ATR 散光移位的模式和幅度在术前散光类型相同的情况下相似。
