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First Author: D.Nahra SPAIN
Co Author(s): O. Martinez A. Martinez
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To calculate the astigmatism correction and central corneal effect of paired opposite clear corneal incisions on the steep axis during cataract surgery.Study design: Non-randomized prospective clinical study.
Hospital De La Esperanza, Barcelona, Spain
40 eyes of 31 consecutive patients that underwent cataract surgery were included and assigned to two different groups depending on the degree of preoperative astigmatism: 20 eyes with astigmatism 1.5D were assigned to the opposite clear corneal incisions (OCCI) group (Study group) and 20 eyes with astigmatism between 0.25 and 1.49 D were assigned to the single incision group (Control group). Routine phacoemulsfication surgery with intraocular lens implantation was performed in both groups except for the double opposite clear corneal incisions group that had a second incision in the steepest meridian at the end of the surgery. Complete ophthalmic examination including keratometry, topography and optical biometry was performed preoperatively and postoperatively.
Mean preexisting astigmatism in the OCCI group (study group) was about 2D and we obtained a mean postoperative astigmatism of 0.73 D±0.73 (p<0.001). Only 3 patients (15%) had a postoperative astigmatism greater than 1.5D. Opposite clear corneal incisions group had a mean astigmatism reduction of 1.92 D (ḟ1.08) compared with the single incisions group (control group) that had an astigmatism correction of only 0.71±0.37D (p<0.001). Patients with greater preoperative astigmatism showed a greater effect. Corneal power (K mean) was reduced significantly in both groups postoperatively (0.6 D for OCCI group vs 0.42 for the single incision group, p>0.05).
OCCI are useful for correcting mild to moderate pre-existing astigmatism during cataract surgery. Our data suggest a possible reduction in spherical equivalent of about 0.59D in these patients.