Evaluation and comparison of surgically induced astigmatism between phacoemulsification and small incision cataract surgery

Abstract

Background: Surgically induced astigmatism is the cause of poor postoperative vision even after uneventful cataract surgery. Aim: The aim of study was to compare the incidence, amount, type, and course of surgically induced astigmatism and visual acuity in temporal 5.5-mm clear corneal phacoemulsification and 6-mm superior scleral incision in Small incision cataract surgery (SICS). Materials and Methods: A total of 200 eyes of 200 patients with a mean age of 62 years were included in the study. Cases were randomly divided into two groups. Group A had undergone 5.5-mm temporal clear corneal phacoemulsification and group B had undergone 6-mm superior scleral SICS. Surgically induced astigmatism was analyzed by SIA software. Results: Mean age in group A was 61 (±8) years and in group B was 63 (±10) years. Mean surgically induced astigmatism in group A was 1.05 (±0.58) D, 1.13 (±0.52) D, 1.13 (±0.56) D, and 1.08 (±0.52) D on 1 st , 7 th , 21 st , and 45 th postoperative days, respectively. The change from 1 st to 45 th day was not significant. The same in group B was 0.75 (±0.58) D, 0.81 (±0.54) D, 0.88 (±0.49) D, and 0.91 (±0.47) D on 1 st , 7 th , 21 st , and 45 th postoperative days, respectively. Surgically induced astigmatism was comparable on all days between the groups. We found significant with the rule and against the rule type of astigmatism post-operatively in the temporal clear corneal incision in phacoemulsification group and in superior scleral incision in small incision cataract surgery group respectively. Conclusion: Surgically induced astigmatism was higher in the 5.5-mm temporal clear corneal group than in the superior scleral group. Clinical outcome of both surgeries was same, as there was no significant difference in the uncorrected postoperative visual acuity in between the groups.