First Author: M.Sorin Simion ROMANIA
Co Author(s): M. Daniela Mariana
Purpose:
This issue is pointing the influence of the incision's size on the surgically induced astigmatism after cataract surgery using phacoemulsification followed by posterior chamber intraocular lens implantation .
Setting:
Retrospective study extended on 4 years , performed in ophthalmology department of Cluj County Hospital , on 648 patients who suffered cataract surgery by phacoemulsification followed by posterior chamber intraocular lens implantation .
Methods:
We performed keratometry to all the patients before and after cataract surgery. We performed immersion biometry with Alcon UltraScan device. Facoemulsification was performed with Alcon Legacy by a 2.75 mm incision, and with Infinity Vision System by a 2.2 mm incision . In both situations, we performed clear corneal incisions. We implanted various types of foldable Acrysof intraocular lenses . Toric intraocular lens were implanted in some patients who presented corneal astigmatism biger than 1,25 diopters before surgery . We excluded from this study the cases in which we performed limbal relaxing incisions . We annalysed the postoperative visual acuity, refraction and surgical induced astigmatism in all the patients three months after surgery.
Results:
: Initial astigmatism was less than 1 diopter at 471 patients, between 1.25 and 2 diopters at 115 patients and biger at 62 patients. 185 patients presented nuclear cataract, 178 patients presented nuclear and posterior subcapsular cataract, 92 patients presented posterior subcapsular cataract, 116 patients presented mature cataract and 77 patients presented cortical cataract. At 316 patients facoemulsification was performed using a 2.75 mm incision and at 352 patients was performed using a 2.2 mm incision. Postoperative refraction showed spheric equivalent values between - 1 Diopters to + 1 Diopters at 594 patients . The rest of the patients presented biger postoperative refraction values. At 149 patients who suffered phacoemulsification throw a 2.75 mm length incision , surgical induced astigmatism was less than 0.4 diopters , and at 136 of those patients surgical induced astigmatism was between 0,5 and 1 diopters ; most of those patients presented hard nucleus cataracts. At 237 patients who suffered phacoemulsification throw a 2.2 mm length incision , surgical induced astigmatism was less than 0.4 diopters , and at 84 of those patients surgical induced astigmatism was between 0,5 and 1 diopters ; most of those patients presented hard nucleus cataracts.
Conclusions:
The size of the incision has a major influence on the surgical induced astigmatism at the patients who suffered cataract surgery by phacoemulsification. The nucleus hardness also influences the values of the surgical induced astigmatism. The phacoemulsification of hard nucleus cataracts requires more intraoperatory manipulations and higher ultrasound energy which can influence incision stress and wound integrity, therefore inducing higher astigmatism. The microincision cataract surgery using phacoemulsification through a 2.2 mm length incision ensures low values of surgical induced astigmatism in 67.3% of cases , and subsequently good postoperative refraction and visual acuity. FINANCIAL DISCLOSURE?: ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented
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