Long-Term Change in Corneal Astigmatism After Sutureless Cataract Surgery

PURPOSE: To compare long-term change in corneal astigmatism with advancing age between eyes that underwent sutureless cataract surgery and those that did not undergo surgery. DESIGN: Case-control study. METHODS: A total of 153 eyes that underwent phacoemulsification with a horizontal incision more than 11 years ago (surgery group) and 153 age-matched control eyes that did not undergo surgery (nonsurgery group) were enrolled. The keratometric cylinder at baseline (at 1 year or more postoperatively in the surgery group) and at 5 and 10 years after baseline was examined. The corneal astigmatic change, as calculated using polar value analysis and vector decomposition analysis, between baseline and 5 years after baseline and between 5 and 10 years was compared between the groups. RESULTS: The mean corneal astigmatic change, specifically Delta KP (90) in the polar analysis and against-the-rule component in the vector analysis, between baseline and 5 years and between 5 and 10 years showed an against-the-rule change in both groups. Using multivariate analysis, no significant difference was found in the corneal astigmatic change between the 2 groups at either time interval (P >= .126). Furthermore, the change between baseline and 5 years was similar to that between 5 and 10 years in both groups (P >= .315). CONCLUSIONS: Corneal astigmatism after sutureless cataract surgery shows a long-term against-the-rule change with advancing age, and this change is similar to that of normal cornea, suggesting that the against-the-rule change that occurs subsequently should be taken into consideration at the time of cataract surgery. (Am J Ophthalmol 2011;151:858-865. (C) 2011 by Elsevier Inc. All rights reserved.)