Corneal changes after a 3 incision cataract surgery by 2.2mm

Abstract

AbstractPurpose a prospective study to analyze the effects of the miniincision coaxial phacoemulsification (2.2 mm) combined with bimanual irrigation/aspiration (I/A) on the corneal optical quality characterized in terms of corneal aberrations.Methods One hundred and eith eyes underwent mini‐incision phacoemulsification, by the same surgeon. Cataract surgery was performed through a clear corneal incision of 2.2mm, placed at 130°. Two paracentesis of 1mm were performed 90° apart for bimanual irrigation/aspiration. An aberrometry (OPD scannII, Nidek®, Japan) was performed preoperatively (Day 0), 15 days after surgery (Day 15) then 1 month after (M1).Results The corneal surgical induced astigmatism (SIA) was quite neutral : 0.091 D +/‐0.428 at Day 15, and 0.065 D +/‐0.86 at Day 30. Between Day 15 and D30, its variation was not significant ‐ 0.026 D +/‐0.871 (p=0.74). At 1 month: we observed a mean reduction of ‐ 0,25D +/‐ 0.96 in the direct astigmatism group (n=46), and a mean induced astigmatism of + 0.23D +/‐ 0.94 in the inverse astigmatism group (n=37), of + 0.21D +/‐ 0.6 in the oblique stigmatism group (n=25).Corneal topographic astigmatism is modified in the axis : mean rotation was 29.95° +/‐ 27.6 between Day 0 and 30. Congenital astigmatism superior to 1,5D appears to be more stable. Corneal asphericity didn’t change statistically between Day 0 and 30 (1.14 D +/‐ 0.5 versus 1.11 D +/‐ 0.49 p=0,13).Conclusion This 3 incision procedure permits a real neutral power SIA through a 2.2 mm main incision, compared to classical coaxial procedure.The stability of refractive data between Day 15 and M1 allows early spectacles prescription and a quick return to normal life. SIA rotation could explain some undercorrections after toric IOL.