Glaucoma surgery and induced astigmatism: a systematic review

Helen H L Chan, Yu Xiang G Kong, Helen H L Chan, Yu Xiang G Kong

Abstract

Background: The refractive outcomes of glaucoma surgeries, particularly their effect on astigmatism, are incompletely understood.

Main body: Trabeculectomy is associated with a considerable amount of with-the-rule astigmatic change in the immediate postoperative period. This is followed by a gradual against-the-rule shift. These changes are altered with the use of mitomycin C (MMC). Non-penetrating surgery such as deep sclerectomy is also associated with a similar or smaller degree of induced astigmatism. Minimally invasive glaucoma surgery appears to be astigmatically neutral. There is no clear evidence regarding refractive outcomes of glaucoma drainage device surgery.

Conclusions: Induced astigmatism may account for a reduction in unaided visual acuity in the early postoperative period following a successful trabeculectomy. These changes appear to stabilise at 3 months, and it would be prudent to defer the prescription of new glasses until this time. If sequential cataract surgery is to be performed, toric intraocular lenses can be a useful option for astigmatic correction.

Keywords: Astigmatism; Filtration surgery; Refractive outcome; Trabeculectomy.

Conflict of interest statement

Ethics approval and consent to participate

Not Applicable.

Consent for publication

Not Applicable.

Competing interests

The authors declare that they have no competing interests.

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