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      Effect of Trabeculectomy on Mean and Centroid Surgically Induced Astigmatism

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      Journal of Clinical Medicine
      MDPI AG

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          Abstract

          This study aimed to investigate the arithmetic mean of surgically induced astigmatism (M-SIA) and the centroid of surgically induced astigmatism (C-SIA) after standard trabeculectomy. We comprised 185 eyes of 143 consecutive patients (mean age ± standard deviation, 67.7 ± 11.6 years) who underwent trabeculectomy and completed at least a 3-month routine follow-up. In all cases, the scleral flap was made at the nasal-superior location. Corneal astigmatism was measured with an automated keratometer. We calculated the M-SIA and the C-SIA using vector analysis and applied the astigmatism double angle plot. The magnitude of corneal astigmatism increased significantly, from 1.17 ± 0.92 D preoperatively to 1.77 ± 1.05 D postoperatively (paired t-test, p < 0.001). The M-SIA was 1.12 ± 0.55 D, and the C-SIA was 0.73 D @64° ± 1.02 D in the right eye group, and the M-SIA was 1.08 ± 0.48 D and the C-SIA was 0.60 D @117° ± 1.03 D in the left eye group. The C-SIA showed an astigmatic shift toward the nasal-superior location of the scleral flap creation. Our results revealed that trabeculectomy induced the SIA in the direction of the scleral flap location and that the C-SIA was much lower than the M-SIA in eyes undergoing trabeculectomy.

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          STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT

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            Reduction of Intraocular Pressure and Glaucoma Progression

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              Contribution of posterior corneal astigmatism to total corneal astigmatism.

              To determine the contribution of posterior corneal astigmatism to total corneal astigmatism and the error in estimating total corneal astigmatism from anterior corneal measurements only using a dual-Scheimpflug analyzer. Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. Case series. Total corneal astigmatism was calculated using ray tracing, corneal astigmatism from simulated keratometry, anterior corneal astigmatism, and posterior corneal astigmatism, and the changes with age were analyzed. Vector analysis was used to assess the error produced by estimating total corneal astigmatism from anterior corneal measurements only. The study analyzed 715 corneas of 435 consecutive patients. The mean magnitude of posterior corneal astigmatism was -0.30 diopter (D). The steep corneal meridian was aligned vertically (60 to 120 degrees) in 51.9% of eyes for the anterior surface and in 86.6% for the posterior surface. With increasing age, the steep anterior corneal meridian tended to change from vertical to horizontal, while the steep posterior corneal meridian did not change. The magnitudes of anterior and posterior corneal astigmatism were correlated when the steeper anterior meridian was aligned vertically but not when it was aligned horizontally. Anterior corneal measurements underestimated total corneal astigmatism by 0.22 @ 180 and exceeded 0.50 D in 5% of eyes. Ignoring posterior corneal astigmatism may yield incorrect estimation of total corneal astigmatism. Selecting toric intraocular lenses based on anterior corneal measurements could lead to overcorrection in eyes that have with-the-rule astigmatism and undercorrection in eyes that have against-the-rule astigmatism. The authors received research support from Ziemer Group. In addition, Dr. Koch has a financial interest with Alcon Laboratories, Inc., Abbott Medical Optics, Inc., Calhoun Vision, Inc., NuLens, and Optimedica Corp. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
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                Journal
                JCMOHK
                Journal of Clinical Medicine
                JCM
                MDPI AG
                2077-0383
                January 2022
                January 03 2022
                : 11
                : 1
                : 240
                Article
                10.3390/jcm11010240
                637d8d4a-ddce-47cb-8a27-74bd784f7334
                © 2022

                https://creativecommons.org/licenses/by/4.0/

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                Self URI (article page): https://www.mdpi.com/2077-0383/11/1/240

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