Abstract
Objective To observe the effect of the corneal astigmatism in cataract surgery incision which selected according to corneal topography to further reduce the preoperative corneal astigmatism. Meth-ods Computer-assisted corneal topography was used to examine the 126 eyes of 123 patients preoperatively.The cases were divided into 5 groups randomly. Group A: Manual small incision cataract surgery (MSICS) Group: Superior anti-bow sclera tunnel incision was made on 22 eyes of Group A. Group B: MSICS Group: The anti-bow sclera tunnel incision was made on the steepest meridian according to the corneal topography ex-amined preoperatively on 28 eyes. Group C: Phacoemulsification Group: Superior clear corneal incision was made on 24 eyes of group C. Group D: Phacoemulsification Group: The clear corneal incision was made on the steepest meridian according to the corneal topography examined preoperatively on 26 eyes. Group E: MSICS Group: incision was made on the steepest meridian according to the corneal topography The straight sclera tun-nel examined preoperatively on 26 eyes. The corneal topography at 1 day and 7 days after surgery was ob-served and recorded except for visual acuity and so on. Results ①Visual acuity: The differences were not sta-tistically significant among these groups which Visual acuity was above 0.5 after 1 day and 7 days except the one between Group B and Group E after 7 days. ②Astigmatism axis conversion: The conversions were not sig-nificant from Group A to Group D. There were 12 cases changed in Group E. ③Corneal astigmatism: In Group A, the differences were not statistically significant among pre-operation, 1 day and 7 days. In Group B, the val-ues of corneal astigmatism in 1 day after surgery were a little more decreased than pre-existing ones, but were statistically significant 7 days later. The values of Group C and D were a little greater in 1 day after surgery and reduced 7 days later, however the values of Group C were higher. In group E, the differences between pre-oper-ation and post-operation were not statistically significant until 7 days later. Comparison of the corneal astigma-tism in Group A and Group B, Group C and Group D, Group A and Group C was not statistically significant.Group B and Group D had statistically significant difference in postoperative corneal astigmatism after 1d but opposite after 7d. On the contrary, Group B and Group E had no statistically significant difference in postopera-tive corneal astigmatism after 1d but opposite after 7d. Conclusions According to the corneal topography, it can reduce the surgical induced astigmatism or the pre-existing astigmatism and improve the visual acuity in short-term. There is an important clinical value to further improve the vision quality in postoperative cataract patients. Key words: Corneal topography; Cataract surgery incision; Corneal astigmatism
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