Advanced Biomedical Research

Corneal astigmatism change and wavefront aberration evaluation after cataract surgery: "Single" versus "paired opposite" clear corneal incisions

Authors

Department of Ophthalmology, Isfahan University of Medical Sciences, Isfa, Iran

Abstract

Background: Correcting the pre-existing astigmatism is an optimal goal in cataract surgery. The aim of this study is to compare the astigmatic correcting effect of a single regular 3.2 mm clear corneal incision (CCI) with paired opposite CCI in cataract patients and effect of these incisions on optical aberrations using the wavefront quantitative analysis.
Materials and Methods: This was a randomized controlled trial study undertaken in an ophthalmology referral center on 50 patients planned for cataract surgery who were randomized to either single 3.2 mm CCI or paired opposite CCI group. Post-operative evaluation was performed at 12 weeks and included refraction, keratometery, corneal topography and wavefront analysis. Corneal astigmatism and post-operative values were compared in two groups.
Results: The mean pre-operative corneal astigmatism was 2.58 ± 1.03 D in the single incision group and 2.70 ± 0.94 D in the paired opposite incisions group. After 12 weeks of surgery, the corneal astigmatism was reached to 2.15 ± 0.82 D in single incision group and 1.63 ± 1.21 in the paired opposite incisions group. There was a statistically significant difference in two arms of treatment regarding to surgically induced astigmatism after 3 months. The mean post-operative total and higher order aberrations and values were not significantly different in two groups.
Conclusion: The results of our study showed that paired opposite incisions is an effective procedure for reducing pre-existing corneal astigmatism in cataract surgery. Paired incisions did not show any beneficial effect regarding wavefront aberrations compared with conventional single incision method.

Keywords

1. Spaeth GL, Danesh-Meyer H, Goldberg I, Kampik A. Ophthalmic Surgery: Principles and Practice. Graefes Arch Clin Exp Ophthalmol, Saunders, Philadelphia: vol. 251, 2011; p. 1047. ISBN 978-1-4377-2250-5.   Back to cited text no. 1
    
2. Ben Simon GJ, Desatnik H. Correction of pre-existing astigmatism during cataract surgery: Comparison between the effects of opposite clear corneal incisions and a single clear corneal incision. Graefes Arch Clin Exp Ophthalmol 2005;243:321-6.  Back to cited text no. 2
    
3. 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.  Back to cited text no. 3
    
4. Tejedor J, Murube J. Choosing the location of corneal incision based on preexisting astigmatism in phacoemulsification. Am J Ophthalmol 2005;139:767-76.  Back to cited text no. 4
    
5. McDonnell PJ, Taban M, Sarayba M, Rao B, Zhang J, Schiffman R, et al. Dynamic morphology of clear corneal cataract incisions. Ophthalmology 2003;110:2342-8.  Back to cited text no. 5
    
6. Rainer G, Menapace R, Vass C, Annen D, Findl O, Schmetterer K. Corneal shape changes after temporal and superolateral 3.0 mm clear corneal incisions. J Cataract Refract Surg 1999;25:1121-6.  Back to cited text no. 6
    
7. Lever J, Dahan E. Opposite clear corneal incisions to correct pre-existing astigmatism in cataract surgery. J Cataract Refract Surg 2000;26:803-5.  Back to cited text no. 7
    
8. Marcos S, Rosales P, Llorente L, Jiménez-Alfaro I. Change in corneal aberrations after cataract surgery with 2 types of aspherical intraocular lenses. J Cataract Refract Surg 2007;33:217-26.  Back to cited text no. 8
    
9. Guirao A, Tejedor J, Artal P. Corneal aberrations before and after small-incision cataract surgery. Invest Ophthalmol Vis Sci 2004;45:4312-9.  Back to cited text no. 9
    
10. Elkady B, Alió JL, Ortiz D, Montalbán R. Corneal aberrations after microincision cataract surgery. J Cataract Refract Surg 2008;34:40-5.  Back to cited text no. 10
    
11. Holladay JT. Optical quality and refractive surgery. Int Ophthalmol Clin 2003;43:119-36.  Back to cited text no. 11
    
12. Tong N, He JC, Lu F, Wang Q, Qu J, Zhao YE. Changes in corneal wavefront aberrations in microincision and small-incision cataract surgery. J Cataract Refract Surg 2008;34:2085-90.  Back to cited text no. 12
    
13. He JC, Gwiazda J, Thorn F, Held R. Wave-front aberrations in the anterior corneal surface and the whole eye. J Opt Soc Am A Opt Image Sci Vis 2003;20:1155-63.  Back to cited text no. 13
    
14. Chylack LT Jr, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL, et al. The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol 1993;111:831-6.  Back to cited text no. 14
    
15. Alpins NA, Goggin M. Practical astigmatism analysis for refractive outcomes in cataract and refractive surgery. Surv Ophthalmol 2004;49:109-22.  Back to cited text no. 15
    
16. Qammar A, Mullaney P. Paired opposite clear corneal incisions to correct preexisting astigmatism in cataract patients. J Cataract Refract Surg 2005;31:1167-70.  Back to cited text no. 16
    
17. Tadros A, Habib M, Tejwani D, Von Lany H, Thomas P. Opposite clear corneal incisions on the steep meridian in phacoemulsification: Early effects on the cornea. J Cataract Refract Surg 2004;30:414-7.  Back to cited text no. 17
    
18. Inoue T, Maeda N, Sasaki K, Watanabe H, Inoue Y, Nishida K, et al. Factors that influence the surgical effects of astigmatic keratotomy after cataract surgery. Ophthalmology 2001;108:1269-74.  Back to cited text no. 18
    
19. Khokhar S, Lohiya P, Murugiesan V, Panda A. Corneal astigmatism correction with opposite clear corneal incisions or single clear corneal incision: Comparative analysis. J Cataract Refract Surg 2006;32:1432-7.  Back to cited text no. 19
    
20. Cooper BA, Holekamp NM, Bohigian G, Thompson PA. Case-control study of endophthalmitis after cataract surgery comparing scleral tunnel and clear corneal wounds. Am J Ophthalmol 2003;136:300-5.  Back to cited text no. 20
    
21. Nagaki Y, Hayasaka S, Kadoi C, Matsumoto M, Yanagisawa S, Watanabe K, et al. Bacterial endophthalmitis after small-incision cataract surgery effect of incision placement and intraocular lens type. J Cataract Refract Surg 2003;29:20-6.  Back to cited text no. 21
    
22. Miller JJ, Scott IU, Flynn HW Jr, Smiddy WE, Newton J, Miller D. Acute-onset endophthalmitis after cataract surgery (2000-2004): Incidence, clinical settings, and visual acuity outcomes after treatment. Am J Ophthalmol 2005;139:983-7.  Back to cited text no. 22
Advanced Biomedical Research
Volume 2014, August
August 2014
Pages 1-5