Changes in Refractive Errors after Cataract Surgery Using Coaxial Incision and IOL Implantation

Purpose: To analyze time-dependent changes in refractive errors after cataract surgery using coaxial incision and IOL implantation. Methods: The analysis data were based on medical records of 180 eyes that were treated for more than 180 days after cataract surgery at the S ophthalmic clinic in Gangneung, Gangwon-do, from March 2014 to June 2019. The ocular examinations and surgery were performed by the same optometrist and the same ophthalmologist, respectively. Changes in refractive errors, visual acuity, and corneal astigmatism were analyzed after surgery for 60 eyes each with emmetropia, myopia, and hyperopia, respectively, classified by pre-surgery refraction. Results: Post-surgery spherical power was changed toward hyperopia compared to expected spherical power before surgery. These changes at 180 days after surgery were +0.47 D (p<0.001) in the hyperopic group, +0.28 D (p<0.001) in the myopia group, and +0.09 D in the emmetropia group. Post-surgery, the cylindrical power decreased gradually and in a time-dependent manner in all groups (p<0.001). The visual acuity was the highest at 30 days and slightly decreased at 180 days (0.96 in the emmetropia group, 0.94 in the myopia group, and 0.95 in the hyperopic group). Corneal astigmatism was significantly decreased (p<0.001) in all groups compared to that at pre-surgery. Conclusions: In the healing process after cataract surgery, refractive errors changed toward hyperopia and coaxial incision can result in a decrease in astigmatism.