M Shakaib Anwar.
Changes in Surgically induced Astigmatism over a period of time after Extracapsular Cataract Extraction.
Pak J Ophthalmol Jan ;15(3):102-4.

It is generally noticed that the incidence of postoperative astigmatism is more when cataract extraction is done through the corneal incision and the more anterior the incision the greater the induced astigmatism. It has been observed that when monofilament nylon suture is used the induced astigmatism is `with-the-rule` and it decays over a period of time even if the sutures are not removed, although this change is more dramatic when total or selective suture cutting is done. Sometimes there Is a shift of `with-the-rule` astigmatism to `against-the-rule`. The maximum changes take place in the first three to six months. A study has been carried out on 79 eyes (78 patients) to observe the natural course (without suture cutting) of surgically induced astigmatism over a period of about one year. Twelve (15.18%) eyes showed no change. Fifty-eight (73.41%) showed changes in astigmatism, while nine eyes (11.39%) showed changes only of spherical error. Mean change observed in astigmatism was of the order of ±0.75DC (diopters cylindrical) and it remained with-the-rule in most of the cases, while the mean change in spherical error was ±0.50 DS (diopters spherical). In another group of patients in whom the natural course was modified by suture cutting the changes in astigmatism were of greater magnitude.

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