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Incisional analysis: the steepest meridian or the most comfortable position?

Poster Details

First Author: A.Urkia Solorzano SPAIN

Co Author(s):    C. Robles Elejalde   J. Alberdi Alberdi   H. Noguera Nunez   I. Romero Moreno           

Abstract Details


A prospective study to assess the corneal incision misalignment, surgically induced astigmatism (SIA), corneal asphericity (Q), irregularity (SAI) and patient final refractive status comparing main incision in cataract surgery, by steepest-meridian (SM) with the most comfortable position (MCP) for the surgeon.


Ophthalmology and Eye Surgery Service. Galdakao-Usansolo Hospital, Galdakao (Basque Country), Spain.


We studied 60 eyes with corneal astigmatism greater than ± 1.50 diopters and no previous surface disease that had phacoemulsification through a 2.2mm corneal clear incision and implantation of Acrysoft® toric intraocular lenses (IOL). All surgeries were performed by the same surgeon and using Centurion® Vision System and Verion™ Image Guided System. Eyes were grouped according to incision location: Group A, by SM besides Group B, by the MCP. Oculus PentacamHR System®, Verion™ Image Guided System, Zeiss IOL-master 500 and anterior segment Optical Coherence Tomography - Cirrus were used preoperatively, and one day and one month postoperatively, during one year.


According to the incision morphology, we noticed that 50% of the eyes, (30 each group) showed incision misalignment, but SM incisions gave more problems at Descemet sprains. We saw that SIA was more stable and lower in the MCP group than in the SM, although not statistically significant. Difference between pre and post-surgery Q was 0.3 in both groups, which meant corneas flatten from the center to the periphery after surgery. In both groups, SAI decreased slightly after surgery, but the difference was bigger in A (0.13) than in B (0.04), and no significant difference was found in refractive cylinder.


Incision suffers less when performing by the MCP. However, there are no statistically significant differences between SIA comparing both incisions. Corneas became prolate after surgery and as toric IOLs were used, the astigmatism highly decreased in both groups.

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