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Clear corneal incision in phacoemulsification to decrease astigmatism and wavefront aberration: a comparison between single and paired opposite incisions

Session Details

Session Title: Assessment of Astigmatism

Session Date/Time: Saturday 05/10/2013 | 11:00-12:30

Paper Time: 11:53

Venue: Main Lecture Hall (Ground Floor)

First Author: : H.Razmjoo IRAN

Co Author(s): :    A. Peyman   N. Koosha           

Abstract Details

Purpose:

To compare effect of paired opposite 3.2mm clear corneal incisions on corneal astigmatism and wavefront aberration after phacoemulsification cataract surgery with single 3.2mm regular corneal incision at steep meridian.

Setting:

Isfahan Ophthalmology Research Center, Isfahan University of Medical Sciences

Methods:

Fifty eyes of 50 patients randomized into paired incision or single incision groups in a prospective study. All patients underwent surgery in single surgical center by a single surgeon. In paired incision group surgeon made first 3.2mm clear corneal incision at steepest meridian, and a second 3.2mm incision exactly 180 degrees apart, plus a 1.5mm stab incision for second instrument at 90 degrees distance. In the single incision group only one 3.2mm incision at steepest meridian and a 1.5mm stab incision created. Standard phacoemulsification surgery proceeded with capsulorhexis, hydro-dissection, vertical chop, and IOL placement. All patients were inserted SA60AT hydrophobic IOL. Subjects evaluated after 3 month regarding their refraction, keratometry, topography, and wavefront aberrations.

Results:

Post-operative refractive corneal plane astigmatism was 1.86 +/- 0.87 diopter in the single incision group, and 1.30 +/- 0.91 diopter in the paired opposite incision group (p: 0.30). Mean keratometric surgically induced astigmatism calculated by analysis of vectors was1.01 +/- 1.02 diopter in single incision group and 1.59 +/- 0.70 in paired opposite incision group (p: 0.02). Topographic mean 3mm central corneal irregularity was 1.72 +/-0.45 and 1.68 +/- 0.66 in single and paired incision groups respectively (p: 0.80).The mean postoperative higher order optical wavefront aberration was 0.66 +/- 0.31 micron and 0.68 +/- 0.38 in single and paired incision groups respectively (p: 0.84).

Conclusions:

Paired opposite 3.2mm clear corneal incisions at steepest meridian during phacoemulsification cataract surgery are more effective than conventional incision for reduction of pre-existing corneal astigmatism. We were not able to disclose any advantage for this technique regarding corneal regularity and wavefront optical aberrations.

Financial Interest:

NONE