EFFECT OF SUPEROTEMPORAL CLEAR CORNEAL INCISION ON PRE EXISTING ASTIGMATISM AFTER PHACOEMUSIFICATION SURGERY
DOI:
https://doi.org/10.55519/JAMC-03-14058Keywords:
Phacoemulsification, Astigmatism, With the rule, Against the rule, superotemporal incision.Abstract
Background: Historically, patients undergoing cataract surgery were at an increased risk of developing surgically induced astigmatism with the advent of modern methods of cataract surgery, the focus shifted towards smaller sized incisions and minimally invasive surgery. Smaller incision produces less post-operative change in astigmatism and early visual rehabilitation as compared to larger incisions. This study was conducted to evaluate and compare the difference between pre and post op corneal astigmatism among patients undergoing phacoemulsification surgery, for cataract, via a superotemporal clear corneal incision. Methods: This was a longitudinal study that enrolled 85 patients between the ages of 40 and 90 years at Ophthalmology Department, Jinnah International Hospital, Abbottabad. Patients were divided into 2 groups according to their pre exiting astigmatism. Group A, With the Rule (WTR), astigmatism and Group B, Against the Rule (ATR) astigmatism. Astigmatism was measured and compared pre operatively, and on day 1, day 7 and day 30 post operatively via auto kerato-refractometer. Results: The mean astigmatism in patients in Group A (WTR astigmatism) preoperatively was 0.76 Diopters, whereas patients in Group B (ATR astigmatism) had a mean pre operative astigmatism of 0.68 Diopters. Mean astigmatism post operatively at day 30 was 0.86 Diopters for Group A, and 1.02 Diopters for Group B. Only 2 out of 36 patients in Group A had a shift to ATR astigmatism, whereas 4 out of 49 patients in Group B had a shift to WTR astigmatism by post op day 30. Conclusion: Superotemporal clear corneal incision is a relatively stable and effective site for incision during phacoemulsification surgery, and causes negligible change in pre operative astigmatism.
References
Schiefer U, Kraus C, Baumbach P, Ungewiß J, Michels R. Refractive errors. DtschArztebl Int. 2016;113(41):693-702. doi:10.3238/arztebl.2016.0693
Sinjab MM. Introduction to astigmatism and corneal irregularities. In: Sinjab MM, Cummings AB, eds. Customized laser vision correction. Cham: Springer International Publishing; 2018:1-64. doi:10.1007/978-3-319-72263-4_1
Ueno Y, Hiraoka T, Beheregaray S, Miyazaki M, Ito M, Oshika T. Age-related changes in anterior, posterior, and total corneal astigmatism. J Refract Surg. 2014;30(3):192-197. doi:10.3928/1081597X-20140218-01
Gelender H. Management of corneal astigmatism after cataract surgery. Refract Corneal Surg. 1991;7(1):99-102.
Cavallini GM, Lugli N, Campi L, Lazzerini A, Longanesi L. Surgically induced astigmatism after manual extracapsular cataract extraction or after phacoemulsification procedure. Eur J Ophthalmol. 1996;6(3):257-263. doi:10.1177/112067219600600306
Zheng L, Merriam JC, Zaider M. Astigmatism and visual recovery after 'large incision' extracapsular cataract surgery and 'small' incisions for phakoemulsification. Trans Am Ophthalmol Soc. 1997;95:387-415.
Moon SC, Mohamed T, Fine IH. Comparison of surgically induced astigmatisms after clear corneal incisions of different sizes. Korean J Ophthalmol. 2007;21(1):1-5. doi:10.3341/kjo.2007.21.1.1
Langenbucher A, Szentmáry N, Cayless A, et al. Surgically Induced Astigmatism after Cataract Surgery - A Vector Analysis. Curr Eye Res. 2022;47(9):1279-1287. doi:10.1080/02713683.2022.2052108
Gurnani B, Kaur K. Phacoemulsification. In: StatPearls. Treasure Island (FL): StatPearls Publishing; June 11, 2023.
Hashemi, Hassan; Khabazkhoob, Mehdi; Soroush, Sara; Shariati, Reyhane; Miraftab, Mohammad; Yekta, Abbasali. The location of incision in cataract surgery and its impact on induced astigmatism. Current Opinion in Ophthalmology 27(1):p 58-64, January 2016. | DOI: 10.1097/ICU.0000000000000223
Linebarger EJ, Hardten DR, Shah GK, Lindstrom RL. Phacoemulsification and modern cataract surgery. SurvOphthalmol. 1999;44(2):123-147. doi:10.1016/s0039-6257(99)00085-5
Piao J, Joo CK. Site of clear corneal incision in cataract surgery and its effects on surgically induced astigmatism. Scientific Reports. 2020 Mar 3;10(1):3955.
Ernest P, Hill W, Potvin R. Minimizing surgically induced astigmatism at the time of cataract surgery using a square posterior limbal incision. J Ophthalmol. 2011;2011:243170. doi:10.1155/2011/243170
Nikose AS, Saha D, Laddha PM, Patil M. Surgically induced astigmatism after phacoemulsification by temporal clear corneal and superior clear corneal approach: a comparison. ClinOphthalmol. 2018;12:65-70
Hazra S, Saha TK. A comparative study of post-operative astigmatism in superior versus superotemporal scleral incisions in manual small incision cataract surgery in a tertiary care hospital. Int J ClinExpOphthalmol. 2021;5:009-15.
Anwar MS. Comparison of pre and postoperative astigmatism after cataract extraction by phacoemulsification through a
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Mohammad Aamir Khan, Zainab Faisal, Bushara Aaqil, Zubairullah Khan, Qazi Maaz Ul Haq
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
