ESCRS - PP12.03 - Wound Ergonomics And Early Post Operative Astigmatism In A 2Mm Manual Small Incision Cataract Surgery With Phacofracture

Wound Ergonomics And Early Post Operative Astigmatism In A 2Mm Manual Small Incision Cataract Surgery With Phacofracture

Published 2024 - 42nd Congress of the ESCRS

Reference: PP12.03 | Type: Free paper | DOI: 10.82333/7knd-r402

Authors: Nilutparna Deori Das* 1 , harsha bhattacharjee 2 , amulya nath sahu 3 , jatinder bali 4

1Pediatric ophthalmology and Strabismus,Sri Sankaradeva Nethralaya,Guwahati,India, 2Comprehensive,Sri Sankaradeva Nethralaya,Guwahati,India, 3Cataract refractive,Sahu Eye Hospital,mumbai,India, 4vitreoretina,Hindu Rao Hospital,New Delhi,India

Purpose

To understand the wound ergonomics of a 2mm incision with back cuts and analyse physics behind the procedure with a mathematical
framework. And to study the morphological changes and effects of the procedure on post-operative astigmatism

Setting

Hospital based, Prospective study

Methods

We created a simple mathematical model describing all the objects and forces involved in performing this technique. A prospective chart analysis of 66 patients who underwent 2mm MSICS with back cuts and foldable intraocular IOL implantation

Results

Mean spherical equivalent of astigmatic error, preoperatively using autorefractor driven inputs was −0.44 diopters, which changed marginally to −0.51 diopters (SD = 0.58) postoperatively.The keratometric difference between steepest and flattest axis of the anterior surface of the central 3 mm zone of the cornea preoperatively ranged from plano to 2.75 diopters with a mean of 0.89 diopters (SD = 0.55).This difference postoperatively had a mean of 1.39 diopters (SD = 1.03).The surgery induced a difference of about half a diopter when a pairwise correlation was done (Z = −3.645, P = 0.00). Corneal endothelial counts were not statistically significant (p=0.01) from the routine manual small-incision and phacoemulsification at 3 months follow-up.

Conclusions

This is an exploratory study and was aimed to present the outcome analysis of this technique using a mathematical framework. It utilizes several novel approaches like early assessment before potential confounding factors related to patient variability can set in. It also uses newer metrics for comparability of the real world data and also index number methods in the future studies. The study raises interest in calculating refraction at anterior and posterior corneal interfaces when the triplanar incision with separate interfaces are used.