Comparison of Surgically Induced Astigmatism Following Manual Sics: Superior and Temporal Approach

Abstract

Aim: The operable cataract cases in the developing world is high compared to the cataract surgical rate, and economical and effective methods are required to deal with this curable blindness, in order to provide the highest achievable uncorrected distance visual acuity. This study aimed to compare the surgically induced corneal astigmatism in patients undergoing manual small incision cataract surgery by superior (s-MSICS) and temporal (t-MSICS) scleral tunnel incisions. Methods: Prospective, interventional cases series of 60 eyes of 60 patients. Uncorrected distance visual acuity (UDVA), mean keratometry (KMean) and surgically induced astigmatism (SIA) were the main outcome measures which were compared between the two groups, s-MSICS and t-MSICS. Results: The mean patient age was 58.60 ± 7.11 years and 59.63 ± 8.39 years in the s-MSICS and t-MSICS groups respectively. Uncorrected distance visual acuity (UDVA) on day 90 was 0.27 ± 0.14 logMAR in the s-MSICS group and 0.18 ± 0.16 logMAR in the t-MSICS group (p=0.05). At the final assessment s-MSICS had 1.43 ± 0.99D of SIA and t-MSICS had 0.76 ± 0.66D of SIA (p=0.02). Four patients in the s-MSICS group and 25 patients in the t-MSICS group had WTR astigmatism (p<0.001). Likewise, there were 26 cases of ATR and one case of ATR in the s-MSICS and t-MSICS respectively (p<0.001). Conclusion: In this prospective study, t-MSICS had significantly lesser surgically induced astigmatism than s-MSICS. The temporal incision decreased against the rule astigmatism, as well, which is the astigmatism prevalent in the adult population.