摘要
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.
