Long-term changes in manifest refraction subsequent to cataract surgery.

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 (J0), 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 J0 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 J0 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 J0 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.