Purpose: To study the changes in corneal aberrations after cataract surgery. Methods: This study comprised 36 eyes of 36 patients (mean age, 67.3 years) who underwent cataract surgery through a 2.2-mm superior sclerocorneal incision. The anterior, posterior, and total corneal wavefront aberrations for the 6.0-mm pupillary diameter were measured preoperatively and 1 month postoperatively. The postoperative changes in corneal aberrations were evaluated for individual Zernike terms (Z2 −2, Z2 0, Z2 2, Z3 −1, Z3 1, and Z4 0) and the root mean squares of the third, fourth, and total higher-order aberrations (S3, S4, and THOA). Results: No significant postoperative changes were observed in S3 and S4 of the total and anterior cornea, although significant changes were observed in S4 and THOA of the posterior cornea. Regarding the preoperative and postoperative Zernike terms of the total cornea, the oblique astigmatism (Z2 −2) changed significantly (P = 0.02). Significant positive correlations were observed in the Z2 −2, Z2 0, Z2 2Z3 −1, Z3 1and Z4 0between the changes in the total and the anterior cornea (P <0.001 for all comparisons). However, no correlations were observed in the changes in the Zernike terms between the total and the posterior cornea, except for the Z2 0. Conclusions: The oblique astigmatism (Z2 −2) of the total cornea significantly changed after 2.2-mm-incision cataract surgery. The changes in the lower- and higher-order aberrations of the anterior cornea mainly contributed to the changes in the total cornea.
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