Natural history of corneal astigmatism after cataract surgery

Jonathan H. Talamo, Walter J. Stark, John D. Gottsch, Daniel F. Goodman, Kimberly Pratzer, Thomas V. Cravy, Cheryl Enger

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Little information on the natural course of corneal astigmatism following cataract surgery exists. We report a prospective, computerized analysis of postoperative astigmatism, based on keratometry measurements, of 137 cases of extracapsular cataract extraction with intraocular lens implantation performed by one surgeon. No sutures were cut postoperatively. Surgery induced 1.44 diopters (D) of with-the-rule astigmatism at one month, which declined at a rate of 0.77 D and 0.35 D per month for the next two months, respectively, with a more gradual decline thereafter. The mean surgically induced astigmatism at the last postoperative visit ranged from 0.29 D at six months (minimum follow-up) to 1.23 D at 48 months; both were against-the-rule. Mean follow-up was 28.92 months. These findings may be technique specific and suggest that (1) corneal curvature continues to change slowly even two to four years postoperatively; (2) most patients develop against-the-rule astigmatism, thus more with-the-rule astigmatism is desirable in the early postoperative period; (3) selective suture removal is necessary only when significantly more than 3.00 D of surgically induced with-the-rule astigmatism is present.

Original languageEnglish (US)
Pages (from-to)313-318
Number of pages6
JournalJournal of cataract and refractive surgery
Issue number3
StatePublished - 1991


  • against the rule
  • corneal astigmatism
  • suture
  • with the rule

ASJC Scopus subject areas

  • General Medicine


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