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. 2018 Jul;32(7):1265-1270.
doi: 10.1038/s41433-018-0072-9. Epub 2018 Mar 14.

Surgically Induced Astigmatism Following Trabeculectomy

Free PMC article

Surgically Induced Astigmatism Following Trabeculectomy

Gyu Ah Kim et al. Eye (Lond). .
Free PMC article


Purpose: Surgically induced astigmatism (SIA) has attracted much interest in recent times because changes in corneal astigmatism can lead to decreased uncorrected visual acuity and patient discomfort. This study aimed to evaluate SIA and to identify factors correlated therewith after trabeculectomy.

Methods: We retrospectively reviewed medical charts of patients who were treated with trabeculectomy at 120° meridian (superotemporal area on right eye and superonasal area on left eye) by the same surgeon. Preoperative keratometric data were compared with data collected from 2 months to 12 months postoperatively. SIA was evaluated using Naeser's polar value analysis.

Results: Using Naeser's method, ΔKP(120) was calculated as 0.7 ± 0.7 (0.82@104°), which indicates a with-the-rule change. After surgery, the combined mean polar values changed significantly (Hotelling T2 = 22.47; p < 0.001). Multivariate analysis of variance indicated that postoperative intraocular pressure and location of surgery were independent factors that were significantly associated with SIA (p = 0.002 and 0.03, respectively).

Conclusions: Trabeculectomy at the 120° meridian was not astigmatically neutral. In addition, the SIA after trabeculectomy appears to be greater in eyes with low postoperative intraocular pressure and a superonasal surgical wound rather than a superotemporal wound.

Conflict of interest statement

The authors declare that they have no conflict of interest.


Fig. 1
Fig. 1
Bivariate analysis of surgical induced astigmatism. The asterisk denotes the combined mean value of polar values and 95% bivariate confidence ellipse is inserted. Δ = change; KP = astigmatic polar value
Fig. 2
Fig. 2
Individual vectorial display of surgically induced astigmatism according to site (a) and postoperative intraocular pressure (b). IOP intraocular pressure

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