The Comparison of Astigmatic Outcomes after Cataract Surgery of Inferior versus Superior Clear Corneal Incision

Jong Kyung Na; Man Soo Kim

doi:10.3341/jkos.2014.55.10.1470

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Na and Kim: The Comparison of Astigmatic Outcomes after Cataract Surgery of Inferior versus Superior Clear Corneal Incision

Original Article

J Korean Ophthalmol Soc 2014;55(10):1470-1475.

Published online: 2 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.10.1470

The Comparison of Astigmatic Outcomes after Cataract Surgery of Inferior versus Superior Clear Corneal Incision

Jong Kyung Na, MD, Man Soo Kim, MD, PhD

Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea

Address reprint requests to Man Soo Kim, MD, PhD, Department of Ophthalmology, The Catholic University of Korea, Seoul St. Mary's Hospital, #222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea, Tel: 82-2-2258-1188, Fax: 82-2-2258-1173 E-mail: mskim@catholic.ac.kr

Received 3 January 2014 Revised 9 April 2014 Accepted 29 August 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze the difference in astigmatism and the mean change in total astigmatism between inferior clear corneal incision and superior clear corneal incision following cataract surgery in surgically-induced astigmatism (SIA). Methods: Fifty-five eyes of 55 patients with with-the-rule astigmatism >0.5 diopters were evaluated. Patients were divided into two groups according to incision location (Group 1, 26 eyes with an inferior incision; Group 2, 29 eyes with a superior incision). Patients were evaluatied one month postoperatively. Uncorrected visual acuity (UCVA, log MAR), best-corrected visual acuity (BCVA, log MAR), SIA and mean change in corneal astigmatism were measured in both groups.

Results

One month postoperatively, mean UCVA was 0.15 ± 0.17 log MAR in Group 1 and 0.23 ± 0.24 log MAR in Group 2 (p = 0.253). Mean BCVA was 0.08 ± 0.13 and 0.08 ± 0.12 log MAR in Groups 1 and 2, respectively (p = 0.926). The SIA was 0.50 ± 0.17 diopter and 0.57 ± 0.34 diopter (p = 0.253) and mean change in total astigmatism was 0.50 ± 0.96 diopter and 0.38 ± 0.86 diopter in Groups 1 and 2, respectively (p = 0.426).

Conclusions

There was no statistically significant difference between the two groups. Thus, corneal incision on the inferior side in patients of with-the-rule astigmatism can reduce the SIA and mean change in corneal astigmatism for patients with glaucoma, hard upper eyelid tension or sunken eye.

Keywords: Cataract surgery, Corneal astigmatism, Inferior clear corneal incision, Superior clear corneal incision, Surgically-induced astigmatism

References

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Figure 1.

Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) in the 2 groups.

Figure 2.

Surgically induced astigmatism (SIA) and change in cylinder (absolute value of preoperative cylinder - absolute value of postoperative cylinder) doesn't show statistically significant difference between 2 groups.

Table 1.

Demographics and preoperative data in each group

	Inferior incision	Superior incision	^*p-value
Number of eyes	26	29
Sex (M/F)	10/16	16/13
Age (years)	55.31 ± 11.60	53.38 ± 11.48	0.224
UCVA (log MAR)	0.75 ± 0.50	0.68 ± 0.36	0.933
BCVA (log MAR)	0.46 ± 0.37	0.40 ± 0.28	0.664
Autorefraction cylinder (diopter)	1.18 ± 0.59	1.14 ± 0.54	0.687
Topographic cylinder (diopter)	1.12 ± 0.65	1.09 ± 0.52	0.906

Values are presented as mean ± SD unless otherwise indicated.

UCVA = uncorrected visual acuity; BCVA = best corrected visual acuity.

^* Mann-Whitney U-test.

Table 2.

Postoperative UCVA (log MAR) and BCVA (log MAR) in both inferior incision group and superior incision group

	Inferior incision	Superior incision	^*p-value
UCVA (log MAR)	0.15 ± 0.17	0.23 ± 0.24	0.253
BCVA (log MAR)	0.08 ± 0.13	0.08 ± 0.12	0.926

Values are presented as mean ± SD.

UCVA = uncorrected visual acuity; BCVA = best corrected visual acuity.

^* Mann-Whitney U-test.

Table 3.

Surgically induced astigmatism and change in cylinder according to preoperative astigmatism in both inferior incision group and superior incision group

	Inferior incision	Superior incision	^*p-value
Surgically induced astigmatism (diopter)	0.50 ± 0.33	0.57 ± 0.34	0.324
Change in autorefraction cylinder (diopter)	0.50 ± 0.96	0.38 ± 0.86	0.426

Values are presented as mean ± SD; Positive result indicates decrease in astigmatism.

^* Mann-Whitney U-test.

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