Refractive changes with corneal incision 2.8mm after phacoemulsification

Document Type : Original Article

Authors

1 Professor of ophthalmology Faculty of Medicine Beni Suef University, Egypt

2 Lecturer of Ophthalmology Faculty of Medicine Beni Suef University, Egypt

Abstract

There are numerous techniques for dealing with astigmatism both during and after cataract surgery. Good uncorrected post-operative distance visual acuity can be obtained for high percentage of cataract patients with pre-existing corneal astigmatism. The goal of this study is to determine the keratometric change and resultant post-operative refraction of routine cataract patients, after a clear corneal incision of 2.8mm on the steeper meridian. Place and Duration of Study: This was a general free hospital-based prospective study.  The study was started from May 2016 and was completed by May 2018.  Methodology: A total of 30 cataract patients were included in this study. Pre-operative keratometric readings were compared with post-operative readings, after a clear corneal incision (CCI) of 2.8mm made during phacoemulsification procedure.  Results: Patients were monitored for four weeks post-operatively. A total of thirty eyes underwent phacoemulsfication cataract surgery with clear corneal incision on steep axis had mean residual astigmatism of 0.45 D and SD achieved 0.58.

Keywords

Main Subjects


  1. Quillen DA (July 1999). "Common causes of vision loss in elderly patients". Am Fam Physician 60 (1): 99–108.
  2. Courtney P (2002). "The National Cataract Surgery Survey: I. Method and descriptive features". Eye (Lond) 6 
  3. Allen D, Vasavada A (2006). "Cataract and surgery for cataract".–
  4. Harper, Douglas (2001). . Retrieved 2007
  5. Bobrow JC, Blecher MH, Glasser DB. Surgery for Cataract. In:Lens and Cataract. Section 11. 2010-2011. Singapore: American Academy of Ophthalmology; 2010:Chap 8.phaco
  6. Kleinstein RN, Jones LA, Hullett S, Kwon S.(2003). "Refractive Error and Ethnicity in Children". Arch Ophthalmol. 
  7. Garcia CA, Oréfice F, Nobre GF, Souza Dde B, Rocha ML, Vianna RN (2005)."[Prevalence of refractive errors in students in Northeastern Brazil.]". Arq Bras Oftalmol(in Portuguese) 68 
  8. Nichamin LD, Chang DF, Johnson SH, Mamalis N, Masket S, Packard RB, Rosenthal KJ; American Society of Cataract and Refractive Surgery Cataract Clinical Committee. ASCRS White Paper: What is the association between clear corneal cataract incisions and postoperative endophthalmitis? J Cataract Refract Surg. 2006 )
  9. Dick HB, Schwenn O, Krummenauer F, Krist R, Pfeiffer N. Inflammation after sclerocorneal versus clear corneal tunnel phacoemulsification. Ophthalmology. 2000
  10. Olsen T, Dam-Johansen M, Bek T, Hjortdal JO. Corneal versus scleral tunnel incision in cataract surgery: a randomized study. J Cataract Refract Surg. 1997
  11. Abrahamsson M, Sjostrand J. Astigmatic axis and amblyopia in childhood.Acta Ophthalmol Scand.2003;81:33–7. 
  12. Brown SA, Weih LM, Fu CL, Dimitrov P, Taylor HR, McCarty CA. Prevalence of amblyopia and associated refractive errors in an adult population in Victoria, Australia. Ophthalmic Epidemiol. 2000;7:249–58. 
  13. Fulton AB, Hansen RM, Petersen RA. The relation of myopia and astigmatism in developing eyes. 1982;89:298–302. 
  14. Gwiazda J, Grice K, Held R, McLellan J, Thorn F. Astigmatism and the development of myopia in children. Vision Res. 2000;40:1019–26. 
  15. Moon, Sung-Chur, Tarek Mohamed, and I. Howard Fine. “Comparison of surgically induced astigmatisms after clear corneal incisions of different sizes.” Korean Journal of Ophthalmology, Vol. 21, No. 1, 2007, pp. 1-5.
  16. Lundström M. Endophthalmitis and incision construction. Curr Opin Ophthalmol. 2006
  17. Jaffe, Norman S., Mark S. Jaffe, and Gary F. Jaffe. Cataract Surgery and Its Complications, 6th Edition. St. Louis: Mosby, 1997.
  18. Gimbel HV, Sun R. Postoperative astigmatism following phacoemulsification with sutured vs. unsutured wounds. Can J Ophthalmol. 1993;28:259–262. 
  19. Ermiº SS, Inan UU, Oztürk F. Surgically induced astigmatism after superotemporal and superonasal clear corneal incisions in phacoemulsification. J Cataract Refract Surg. 2004;30:1316–9. 
  20. Duke-Elder S, Wybar KC. System of Ophthalmology. Vol. 2. London: Henry Kimpton; 1961. The Anatomy of the Visual System.
  21. Kohnen S, Neuber R, Kohnen Effect of temporal and nasal unsutured limbal tunnel incisions on induced astigmatism after phacoemulsification. J Cataract Refract Surg. 2002;28:821–5.
  22. Bazzazi, Noushin. “Opposite clear corneal incisions versus steep meridian incision phacoemulsification for correction of pre-existing astigmatism.” Journal of Ophthalmic and Vision Research, Vol. 3, No. 2, 2008, p. 87.
  23. Khan, Akbar. “Effect of incision site on pre-existing astigmatism in phaco-emulsification.” Pak J Ophthalmol, Vol. 30, No. 1, 2014, pp. 45-48.
  24. Anwar, M. Shakaib. “Comparison of Pre and Postoperative Astigmatism after Cataract Extraction by Phacoemulsification through a 3.2 MM Clear Corneal Superotemporal Incision.” Pakistan Journal of Ophthalmology, Vol. 30, No. 3, 2014, p. 156.
  25. Harakuni, Umesh. “A longitudinal study to evaluate the effect of surgically induced astigmatism after phacoemulsification clear corneal incision placed in the steepest meridian on eyes with preexisting astigmatism.” Indian Journal of Health Sciences and Biomedical Research, Vol. 9, No. 2, 2016, p. 179.
  26. Rho, Chang Rae, and Choun-Ki Joo. “Effects of the steep meridian incision on corneal astigmatism in phacoemulsification cataract surgery.” Journal of Cataract and Refractive Surgery, Vol. 38, No. 4 2012, pp.666-71.
  27. He, Y. “Comparison of the keratometric corneal astigmatic power phacoemulsification: clear temporal corneal incision versus superior scleral tunnel incision.” Journal of Ophthalmology, 2009, pp. 1-3.