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Effect of temporal scleral curvilinear manual small incision cataract surgery (MSICS), temporal scleral straight line manual small incision cataract surgery (MSICS) and temporal limbal phacoemulsification on against-the-rule (ATR) astigmatism of ≥1D

Poster Details

First Author: K.Palanisamy INDIA

Co Author(s):    P. Amudha   T. Arun   R. Amudhavalli   B. Geeta   J. Arokiam   P. Neeta

Abstract Details



Purpose:

To compare the change in astigmatism produced by three surgical procedures - temporal scleral tunnel curvilinear manual small incision cataract surgery (MSICS), temporal scleral tunnel straight line manual small incision cataract surgery (MSICS) and temporal limbal phacoemulsification in patients with against-the-rule (ATR) astigmatism of ≥1 dioptre.

Setting:

Prospective, hospital based, consecutive assignment, randomized (block randomization) study in uncomplicated cataract eyes with ATR astigmatism ≥1 dioptre

Methods:

Patients presenting with cataract and ATR astigmatism of ≥1 dioptre were randomly assigned to 3 groups with 35 patients in each group - Group A: temporal scleral tunnel curvilinear MSICS(7mm incision), Group B: temporal scleral tunnel straight line MSICS(7mm incision) and Group C: temporal phacoemulsification(2.8mm incision). Preoperative Keratometry was compared with post operative Keratometry at 6 weeks.

Results:

A shift of astigmatism towards neutralization was noticed in the postoperative astigmatism in all the three groups. The mean preoperative astigmatism in group A was 1.81±1.02 and the mean postoperative astigmatism was 0.92±0.75.The mean preoperative astigmatism in group B was 1.57±0.76 and the mean postoperative astigmatism was 0.96±0.51. The mean preoperative astigmatism in group C was 1.47±0.66 and the mean postoperative astigmatism was 1.39±0.76.The difference in the reduction in the mean astigmatism between the three groups was statistically significant. Group A - 0.89, Group B- 0.62 and Group C - 0.086 (p<0.001)

Conclusions:

All patients had preexisting ATR astigmatism of ≥ 1 dioptre and a tendency towards neutralization of the astigmatism was observed in all cases. This effect was greater in the temporal scleral tunnel curvilinear incision MSICS and temporal scleral tunnel straight line incision MSCIS as compared to temporal phacoemulsification. Temporal scleral tunnel curvilinear incision MSICS had the best result in our study. We conclude that temporal scleral tunnel (curvilinear or straight line incision) MSICS gives better result in ATR astigmatism ≥1 dioptre as compared to temporal phacoemulsification. The sutureless manual small incision cataract surgery (MSICS) is comparable to phacoemulsification in good visual results at lower expense in ATR astigmatism ≥1 dioptre. MSICS, an emerging method of cataract surgery, is fast, safe, easy to learn and needs fewer resources. FINANCIAL INTEREST: NONE

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