Effect Of Clear Corneal Paired Wounds On Corneal Astigmatism During Phacoemulsification Surgery

To evaluate the role of clear corneal incisions during phacoemulsification surgery in minimizing surgically induced astigmatism and partially correcting pre-existing corneal astigmatism by strategic placement of single or paired incisions on the steep corneal meridian.

This study was conducted at Cairo Fatemic Hospital, Cairo, Egypt. Forty patients with age-related cataract and pre-existing corneal astigmatism undergoing phacoemulsification were included. Patients were recruited from the ophthalmology outpatient clinic and evaluated preoperatively with full ophthalmic examination and keratometry. Surgeries were performed under standardized conditions using clear corneal incisions placed on the steep corneal meridian.

This prospective clinical study was conducted at Cairo Fatimic Hospital and included 40 patients undergoing phacoemulsification cataract surgery. Preoperative keratometric measurements were used to identify the steep corneal meridian. Clear corneal incisions were strategically placed on the steep meridian in order to minimize additional astigmatism and achieve partial correction of pre-existing corneal astigmatism. In selected cases, paired clear corneal incisions were utilized to enhance the astigmatic effect. Postoperative keratometric measurements were compared with preoperative values to assess the magnitude of astigmatic correction.

Placement of the clear corneal incision on the steep meridian resulted in a reduction of pre-existing corneal astigmatism. Each clear corneal incision produced an average flattening effect ranging from 0.75 to 1.0 diopter. In cases where paired incisions were used, a greater reduction in corneal astigmatism was observed. The technique effectively reduced astigmatism while avoiding significant surgically induced astigmatism.

Strategic placement of clear corneal incisions during phacoemulsification on the steep corneal meridian can serve as a simple and effective method to reduce pre-existing corneal astigmatism while minimizing surgically induced astigmatism. This technique may provide an additional refractive benefit without requiring specialized instruments or additional surgical procedures.