Abstract
Purpose: To compare the astigmatism induced by a superior versus temporal incision in manual small incision cataract surgery (SICS) in eyes preoperative with the corneal astigmatism (WTR). Methods: A prospective comparative study was carried on 35 eyes of 24 patients. All of them had senile cataract and were selected from Ain Shams university hospitals ophthalmology outpatient clinic. The patients were subdivided into 2 groups according to site of incision. Group A: 18 eyes (of 13 patients) underwent SICS through superior approach implantation of PMMA IOL. Group B: 17 eyes (of 11 patients) underwent SICS through temporal approach implantation of PMMA IOL. The SIA was then calculated for each eye (at day 45 postoperative) and compared. Results: Mean surgical-induced astigmatism (SIA) was found to be significantly lower in the temporal group compared to that in the superior group (P<0.01). The superior incision induced 2.1 D of against the rule astigmatism (ATR). While the temporal incision induced 0.7 D of WTR astigmatism. Conclusion: The high SIA induced by superior incision may prove useful when aimed at reducing high levels of preoperative corneal WTR astigmatism (around 2 D). On the other hand, temporal incision is recommended in patients low levels of preoperative WTR astigmatism. The exact cut-off value is to be studied.
Highlights
Cataract surgery has become one of the most common and successful procedures in ophthalmology
As regards the choice of incision location, previous studies reported that superior incision induces greater corneal astigmatic change (ATR), than temporal incision (WTR) [3,4,5]
There were no significant differences in the age, sex, or preoperative astigmatism between the two groups (Table 1)
Summary
Cataract surgery has become one of the most common and successful procedures in ophthalmology. In addition to improving visual acuity (VA), one of the goals of modern cataract surgery is to reduce pre-existing astigmatism (PEA), a factor that may reduce VA and affect the quality of vision [1]. Various strategies currently available to the cataract surgeon can safely and effectively reduce corneal astigmatism during lensbased surgery. These techniques require careful preoperative surgical planning as regards incision design and site. With-therule astigmatism is preferred as it frequently allows better uncorrected visual acuity [6]. Others recommend choosing the location of corneal incision based on preexisting astigmatism by placing the incision on the steeper corneal meridian (on-axis incision) to reduce significant preoperative astigmatism [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
