The Effect of Manipulation of Corneal Incision on Astigmatism During the Cataract Surgery

Sohee Jeon; Kyung Sun Na; Man Soo Kim

doi:10.3341/jkos.2010.51.4.510

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Jeon, Na, and Kim: The Effect of Manipulation of Corneal Incision on Astigmatism During the Cataract Surgery

Original Article

J Korean Ophthalmol Soc 2010;51(4):510-515.

Published online: 25 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.4.510

The Effect of Manipulation of Corneal Incision on Astigmatism During the Cataract Surgery

Sohee Jeon, MD, Kyung Sun Na, MD, Man Soo Kim, MD, PhD

Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea

Address reprint requests to Man Soo Kim, MD, PhD Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University #505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea Tel: 82-2-2258-2846, Fax: 02-599-7405, E-mail: mskim@catholic.ac.kr

Received 23 March 2009 Accepted 19 January 2010

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 evaluate the effect of clear corneal incisional size on astigmatism during cataract surgery.

Methods

Randomized prospective study of 78 patients (108 eyes) who had received cataract surgery for a corneal astigmatism over against-the-rule (ATR) 1.0 Diopter (D) was performed. The eyes were checked by corneal topography and autorefractor preoperatively and one week, one month, two months, and six months postoperative. Group 1 included patients who received an inserted foldable intraocular lens (IOL) through a 2.8 mm incision, and Group 2 included patients who underwent IOL implantation through a corneal incision enlarged to 4 mm.

Results

Postoperative visual acuity showed a better visual acuity in Group 2 at both one week postoperatively (0.598±0.352 vs., 0.713±0.345, for Groups 1 and 2, respectively, p=0.046) and one month postoperatively (0.604±0.237 vs., 0.791±0.242, respectively, p=.043). There were no statistically significant differences between the groups after two and six months (p=.135, .087). Postoperative astigmatism measured by corneal topopgraphy showed 1.62±0.44D and, 0.94±0.30D for groups 1 and 2 respectively, (P=.045) at 2 months, and 1.73±0.45 D and, 0.92±0.34 D (P=.042) at six months. These results showed a statistically significant amount of residual astigmatism in Group 2. Autorefractor measurements showed similar results. There were no complications, such as wound leakage, resulting from the increased incision size.

Conclusions

Widening of the incision during cataract surgery can reduce corneal astigmatism without significant complications.

Keywords: Cataract surgery, Corneal astigmatism, Incision size

References

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Figure 1.

The uncorrected visual acuity (UCVA) in the 2 groups (^* p<0.05).

Figure 2.

The mean astigmatism (D) in 2 groups by autorefractor (A), and topography measurement (B). (^*p<0.05).

Figure 3.

A: Preoperative topographic cylinder (D), B: Residual topographic cylinder (D) at 6 months.

Figure 4.

Scattergram of preoperative versus difference between preoperative and postoperative absolute astigmatism at 6 months in 4.0 mm incision group (R²=0.784, p<0.05).

Table 1.

Demographics and preoperative astigmatism of the 2 groups

	Group1	Group2	P value
Eye	57	51
Age	65.6±11.52	68.1±12.43	0.846
Gender (M:F)	21:36	28:23
Follow-up period (days)	118±31	130±38	0.946
UCVA	0.302±0.146	0.372±0.112	0.536
BCVA	0.470±0.227	0.438±0.237	0.623
Autorefractor: Cylinder (D)	2.17±0.61	2.21±0.59	0.891
Topography: Cylinder (D)	2.12±0.39	2.22±0.65	0.672

Group1: 2.8 mm incision group; Group2: 4.0 mm incision group.

^* UVCA: uncorrected visual acuity

^† BCVA: best corrected visual acuity.

Table 2.

Preoperative and postoperative visual acuity of the 2 groups

	Group1	Group2	P value
UCVA^*
Preoperative (n=108)	0.302±0.146	0.372±0.112	0.536
Postoperative 1 week (n=107)	0.598±0.352	0.713±0.345	0.046
Postoperative 1 month (n=106)	0.604±0.237	0.791±0.242	0.043
Postoperative 2 months (n=100)	0.693±0.337	0.827±0.233	0.135
Postoperative 6 months (n=92)	0.713±0.346	0.802±0.213	0.087
BCVA^†
Preoperative (n=108)	0.470±0.227	0.438±0.237	0.623
Postoperative 1 week (n=107)	0.824±0.287	0.831±0.269	0.874
Postoperative 1 month (n=106)	0.862±0.134	0.895±0.255	0.607
Postoperative 2 months (n=100)	0.932±0.176	0.903±0.168	0.771
Postoperative 6 months (n=92)	0.913±0.137	0.904±0.204	0.787

Group1: 2.8 mm incision group; Group2: 4.0 mm incision group.

^* UVCA: uncorrected visual acuity

^† BCVA: best corrected visual acuity.

Table 3.

The mean astigmatism in the 2 groups by autorefractor and mannual keratometry

	Group 1	Group 2	P value
Autorefractor: Cylinder (D)
Preoperative (n=108)	2.17±0.61	2.21±0.59	0.891
Postoperative 1 week (n=107)	1.57±0.51	0.93±0.26	0.026
Postoperative 1 month (n=106)	1.62±0.55	0.88±0.31	0.031
Postoperative 2 months (n=100)	1.65±0.42	0.91±0.23	0.044
Postoperative 6 months (n=92)	1.71±0.42	0.90±0.35	0.041
Topography: Cylinder (D)
Preoperative (n=96)	2.12±0.39	2.22±0.65	0.672
Postoperative 1 week (n=95)	1.55±0.48	0.94±0.24	0.037
Postoperative 1 month (n=93)	1.67±0.54	0.87±0.39	0.050
Postoperative 2 months (n=85)	1.62±0.44	0.94±0.30	0.045
Postoperative 6 months (n=82)	1.73±0.45	0.92±0.34	0.042

Group1: 2.8 mm incision group; Group2: 4.0 mm incision group.

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