The effect of suture presence or position of intraocular lens was evaluated on the astigmatic changes in cataract patients suffering from with-the-rule astigmatism who underwent temporal clear corneal incision cataract surgeries.

According to the presence or absence of suture and the lens position (either 180°or 90°), 49 eyes of 47 patients were divided into four groups. Astigmatism was determined using an autorefractor and by topography before surgery, and at one day, one week, one month, and two months after surgery.

The suture group showed significant reduction in astigmatism at postoperative day 1 and week 1 by autorefractor and topography compared with the non-suture group. The group with intraocular lens insertion axis at 180° did not show significant reduction of astigmatism by autorefractor evaluation. Astigmatism determination by topography in this group was 1.00±0.73D, 1.01±0.77D and 1.01±0.81D at postoperative week 1, month 1, and month 2, respectively, and this showed significant reduction of astigmatism compared with preoperative astigmatism (1.32±1.17D) and group with intraocular lens insertion axis at 90°. In particular, the group with the sutured temporal incision and with an inserted intraocular lens axis at 180° showed significant reduction of astigmatism by autorefraction.

When performing cataract surgery in with-the-rule astigmatism patients, suturing the temporal incision and inserting the intraocular lens axis at 180° can reduce astigmatism and minimize the effect of surgically-induced astigmatism.