First Author: C.Cagini ITALY
Co Author(s): C. Lupidi T. Fiore F. Pietrolucci A. Cerquaglia
Purpose:
To compare a transconjunctival single-plane sclerocorneal incision with 2 tiny conjunctival cuts at both ends and a clear corneal incision (CCI) in cataract surgery on induced astigmatism, and post-operative discomfort caused to the patient.
Setting:
Department of Ophthalmology, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
Methods:
Patients having routine cataract surgery were randomly divided in 2 groups based on incision type: 50 patients in transconjunctival sclerocorneal incision (SCI) group and 50 patients in clear cornea incision (CCI) group. Patients were visited both before the surgery and the 1st, 30th and 90th day after; in each visit were recorded visual acuity, anterior segment biomicroscopy, intraocular pressure, posterior segment biomicroscopy, corneal topography (Sirius CSO) and endothelial cell density. At the end of every visit a questionary regarding potential post-operative ocular disturbs was submitted to the attention of the patient: stinging, feeling of an external body and/or lachrymation, giving any voice a score from 1 to 5 (1 was very low- 5 very high score).
Results:
The topographic informations collected during the post-operative checks carried out after 1 and 3 months ( K1, K2, Km, spherical equivalent cylinder) did not highlight any statistically significant difference :Km preop 43.9 sd 1,4, Km postop at 3 months 43,9 sd 1,5 (P >0.05) in terms of induced astigmatism among the 2 different cut methods. Instead we have found a material difference regarding the post-operative discomfort post 3 months: 6,66% of the patients in SCI group and 15% of the patients in the CCI group had stinging; 13,3% of the patients in CCI group and 10% in SCI group had lachrymation; no one in SCI group and 15% of the patients in CCI group had feeling of an external body in the eye. Moreover after 3 months the SCI method allows to preserve the 92,3% of endothelial cells instead of the 84,9 % obtained by CCI. The average post-operative visual acuity after 3 months is very high (8.97/10 in the corneal cut, 9,67/10 in the sclerocorneal cut), and in any case we did not have any complication neither in the intraoperative nor in the postoperative.
Conclusions:
The two methods of cut are fungible in terms of functional results, the post-operative induced astigmatism and the intra-operative safety. The sclerocorneal cut involves lower post-operative discomfort both at short and long term, and assures a lower endothelial cell loss at 3 months. FINANCIAL DISCLOSURE?: No
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