Abstract
Purpose To analyse the early surgically induced corneal astigmatism (SICA) with a 3.5 mm oblique clear corneal incision (CCI) for phacoemulsification and flexible silicone implant.
Methods Sixty-four consecutive patients were included in this study. The keratometry readings were recorded on the day prior to surgery, the first day post-operatively and at 6 weeks. The SICA was evaluated according to four different methods: (i) simple subtraction, (ii) vector analysis, (iii) vector decomposition and (iv) Naeser polar values.
Results At 6 weeks post-operatively the SICA was equally divided between with-the-rule (WTR) and against-the-rule (ATR) astigmatism, according to the vector analysis in combination with vector decomposition. Both the simple subtraction method and Naeser polar values were misleading.
Conclusion The oblique clear corneal section for phacoemulsification is a comfortable and safe incision with a predictable and acceptable degree of SICA that may be better tolerated than that induced by superior incision.
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References
Gills JP, Sanders DR . Use of small incisions to control induced astigmatism and inflammation following cataract surgery. J Cataract Refract Surg 1991;17:740–4.
Steinert RF, Brint SF, Whites SM, Fine IH . Astigmatism after small incision cataract surgery: a prospective randomised, multicentre comparison of 4 and 6.5 mm incisions. Ophthalmology 1991;98:417–23.
Shephard JR . Induced astigmatism in small incision cataract surgery. J Cataract Refract Surg 1989;15:85–8.
Fine IH . Self sealing corneal tunnel incision for small incision cataract surgery. Ocular Surg News 1992;[1 May]:38–9.
Bradbury JA, Hillman JS, Cassels-Brown A . Optimal postoperative refraction for good unaided near and distance vision with monofocal intraocular lenses. Br J Ophthalmol 1992;76:300–2.
Axt JC, McCaffery JM . Reduction of postoperative against the rule astigmatism by lateral incision technique. J Cataract Refract Surg 1993;19:380–6.
Nielsen PJ . Prospective evaluation of surgically induced astigmatism and astigmatic keratotomy effects of various self sealing small incisions. J Cataract Refract Surg 1995;21:417–24.
Kohnen T, Dick B, Jacobi KW . Comparison of induced astigmatism after temporal, clear corneal tunnel incisions of different sizes. J Cataract Refract Surg 1995;21:417–24.
Langerman DW . Architectural design of a self-catering corneal tunnel, single-hinge incision. J Cataract Refract Surg 1994;20:84–8.
Naylor EJ . Astigmatic difference in refractive error. Br J Ophthalmol 1968;52:422–4.
Jaffe NS, Dayman HM . The pathophysiology of corneal astigmatism after cataract extraction. Trans Am Acad Ophthalmol Otolaryngol 1975;79:615–30.
Naeser K . A new method to describe the surgically-induced change in corneal astigmatism. Acta Ophthalmol (Copenh) 1989;Suppl 195:33–6.
Olsen T, Dam-Johansen M . Evaluating surgically induced astigmatism. J Cataract Refract Surg 1994;20:517–22.
Pfleger T, Skorpik C, Menapace R, Scholz U, Weghaupt H, Zehetmayer M . Long-term course of induced astigmatism after clear corneal incision cataract surgery. J Cataract Refract Surg 1996;22:72–7.
Grabow HB . The clear corneal incision. In: Fine IH, Fichman RA, Grabow HB, editors. Clear-corneal cataract surgery and topical anaesthesia. Thorofare, NJ: Slack, 1993:29–62.
Lindstrom RL . Cataract surgery and lens implantation. Curr Opin Ophthalmol 1994;5:1–4.
Fine IH . Corneal tunnel incision with a temporal approach. In: Fine IH, Fichman RA, Grabow HB, editors. Clear corneal cataract surgery and topical anaesthesia. Thorofare, NJ: Slack, 1993:5–26.
Kammann J, Dornbach G, Schuttrumpf R . Nahtlose korneale Kleinschnittchirurgie. Indikationen und klinische Ergebnisse. Ophthalmo Chirurgie 1993;5:28–32.
Kammann J, Dornbach G, Schuttrumpf R . Ergebnisse nach kornealer und skleraler Kleinschnittchirurgie mit Linsenimplantationen. In: Robert YCA, Gloor B, Harmann C, Rochels R, editors. 7. Kongress der Deutschsprachigen Gesellschaft fur Intraokularlinsen Implantation. Berlin: Springer, 1993:120–5.
Kammann JP, Dornbach G . Long-term results and indications for clear corneal surgery. Eur J Implant Refract Surg 1995;7:97–100.
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Mercieca, F., Luck, J. Early induced astigmatism following phacoemulsification and flexible lens implantation through an oblique corneal tunnel. Eye 12, 630–633 (1998). https://doi.org/10.1038/eye.1998.158
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DOI: https://doi.org/10.1038/eye.1998.158