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Increasing clear corneal incision size does not increase astigmatism
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VERACRUZ, Mexico - Increasing the incision size slightly in clear corneal cataract surgery does not induce additional astigmatism, according to a surgeon speaking here.
Karina Ramos Espinoza, MD, presented the results of a prospective, observational study at the Mexican Congress of Ophthalmology, which concluded here Wednesday.
Surgically induced astigmatism can be an important determinant of a patient’s visual recovery after cataract surgery, Dr. Ramos Espinoza said. Therefore, she and colleagues in Guadalajara, Mexico, sought to demonstrate that a change in incision size does not increase postoperative induced astigmatism.
The study included 88 eyes of 72 patients that underwent phacoemulsification with clear corneal incisions larger than 3 mm. In all patients, the incision was increased to 3.75 mm for implantation of the IOL. Thirty-eight eyes (43%) received hydrophobic acrylic lenses and 50 eyes (57%) received hydrogel lenses.
Keratometric measurements were taken before surgery and at 1 and 6 weeks postop. Snellen visual acuity was also measured.
Postoperatively, 78% of eyes had a VA of 20/30 or better. Worse vision in the other eyes was attributed to the presence of macular pathology, Dr. Ramos Espinoza said.
In the patients implanted with acrylic lenses, mean astigmatism of 0.34 D was measured at 1 week postoperatively, decreasing to 0.23 D at 6 weeks postop. Patients who received hydrogel lenses had mean astigmatism of 0.31 D at 1 week and 0.13 D at 6 weeks.
“We concluded that with small clear-corneal incisions that are increased to 3.75 mm, we induce neutral astigmatism. These days, with the injectors that are used, the incisions can be smaller, but this could be an option for those cases when the use of forceps is required,” Dr. Ramos Espinoza said.