Surgically induced astigmatism in frown versus chevron incision in MSICS

Abstract

Cataract surgery remains the foremost cause of reversible blindness globally. Phacoemulsification requires expensive equipment, instruments and higher cost of disposables, along with a longer training curve. Manual small incision cataract surgery (MSICS) has evolved to provide excellent postoperative results, with minimal cost. In developing countries like India, patients present with white/advanced cataract, for which MSICS has proven to provide the best results. MSCIS can be used in any type of cataract, with any type of foldable/rigid intraocular lens implantation. Minimising surgically induced astigmatism is of paramount importance as the patient achieves good uncorrected vision postoperatively, which is the need of the hour. The Chevron incision in MSICS has been reported to provide the best results. We undertook the present study in 100 eyes with white cataract/nuclear sclerosis of grade 4-6 to analyse and compare MSCIS through the Frown incision and Chevron incision. The mean surgically induced astigmatism incision was more in the Frown group (0.82D±0.62) than in the Chevron group (0.55D±0.42), which was statistically significant. (p 0.017). In the Frown versus Chevron group, the best uncorrected visual acuity was 6/12 or better in 62% and 82% respectively. Thus, the Chevron incision was superior to the Frown incision for MSICS, while both yielded good postoperative results. MSICS is the most affordable and effective surgery of choice, especially for white/ hard cataracts.