Management of pre-existing regular astigmatism in phacoemulsification

Abstract

Objectives The objective of this study was to compare the effect of single clear corneal incision (CCI) on the steep axis with opposite clear corneal incisions (OCCIs) on pre-existing regular corneal astigmatism in cataract patients having phacoemulsification. Background Correction of pre-existing regular astigmatism in phacoemulsification. Patients and methods This randomized prospective clinical study included 30 eyes of 30 cataract patients with corneal regular astigmatism greater than 1 D. The patients were randomly divided into two groups, each group involving 15 eyes. Paired 3 mm CCI were made on the steep axis in Group A and single in Group B. Preoperative evaluation included uncorrected visual acuity, refraction, best-corrected visual acuity, applanation tonometry, fundus examination, biometry, keratometry, and corneal topography. The vertical axis was marked before peribulbar anesthesia was given and routine phacoemulsification was performed through a 3-mm CCI on the steep axis. An additional opposite 3-mm self-sealing CCI was made opposite to the first one in Group A. Patients were examined 2, 4, and 8 weeks postoperatively. Visual acuity, refraction, keratometry, and corneal topography were used to evaluate the improvement. Results The mean preoperative and postoperative topographic corneal astigmatism was 1.95 D ± 0.83 (SD), 0.59 D ± 0.47 (SD) and 1.93 D ± 0.51 (SD), 1.53 D ± 0.62 (SD), respectively, in Groups A and B. There was a significant difference between the mean values of astigmatism in the two groups postoperatively. The mean surgically induced astigmatism, measured by a vector-corrected method, was 1.2 ± 80.11 D and 1.09 ± 0.13 D in Group A and Group B, respectively ( P = 0.00). The mean values of best-corrected visual acuity were 0.11 ± 0.13 in Group A and 0.22 ± 0.15 in Group B postoperatively ( P Conclusion OCCIs on the steep axis were more effective than single CCI in the correction of mild to moderate pre-existing corneal astigmatism.