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Clear corneal incision in phacoemulsification to decrease astigmatism and wavefront aberration: a comparison between single and paired opposite incisions
Session Title: Assessment of Astigmatism
Session Date/Time: Saturday 05/10/2013 | 11:00-12:30
Paper Time: 11:53
Venue: Main Lecture Hall (Ground Floor)
First Author: : H.Razmjoo IRAN
Co Author(s): : A. Peyman N. Koosha
To compare effect of paired opposite 3.2mm clear corneal incisions on corneal astigmatism and wavefront aberration after phacoemulsification cataract surgery with single 3.2mm regular corneal incision at steep meridian.
Isfahan Ophthalmology Research Center, Isfahan University of Medical Sciences
Fifty eyes of 50 patients randomized into paired incision or single incision groups in a prospective study. All patients underwent surgery in single surgical center by a single surgeon. In paired incision group surgeon made first 3.2mm clear corneal incision at steepest meridian, and a second 3.2mm incision exactly 180 degrees apart, plus a 1.5mm stab incision for second instrument at 90 degrees distance. In the single incision group only one 3.2mm incision at steepest meridian and a 1.5mm stab incision created. Standard phacoemulsification surgery proceeded with capsulorhexis, hydro-dissection, vertical chop, and IOL placement. All patients were inserted SA60AT hydrophobic IOL. Subjects evaluated after 3 month regarding their refraction, keratometry, topography, and wavefront aberrations.
Post-operative refractive corneal plane astigmatism was 1.86 +/- 0.87 diopter in the single incision group, and 1.30 +/- 0.91 diopter in the paired opposite incision group (p: 0.30). Mean keratometric surgically induced astigmatism calculated by analysis of vectors was1.01 +/- 1.02 diopter in single incision group and 1.59 +/- 0.70 in paired opposite incision group (p: 0.02). Topographic mean 3mm central corneal irregularity was 1.72 +/-0.45 and 1.68 +/- 0.66 in single and paired incision groups respectively (p: 0.80).The mean postoperative higher order optical wavefront aberration was 0.66 +/- 0.31 micron and 0.68 +/- 0.38 in single and paired incision groups respectively (p: 0.84).
Paired opposite 3.2mm clear corneal incisions at steepest meridian during phacoemulsification cataract surgery are more effective than conventional incision for reduction of pre-existing corneal astigmatism. We were not able to disclose any advantage for this technique regarding corneal regularity and wavefront optical aberrations.