Effect of corneal incision features on anterior and posterior corneal astigmatism and higher‐order aberrations after cataract surgery

Abstract

To evaluate the influence of 2.2 mm clear corneal incision (CCI) features in surgically induced astigmatism (SIA) and higher-order aberrations (HOAs) after cataract surgery. Methods: Right eyes of 92 subjects receiving 2.2 mm incision cataract surgery were involved. A total of 38 eyes were categorized as the intact incision group, and 54 eyes were the defective incision group. Pre-and postoperative (1 month and 6 months) corneal astigmatism and HOAs on anterior and posterior corneal surfaces, corneal volume, and corneal thickness (CT) were measured using Pentacam. The CCI features including incision length (IL), incision angles, distance from incision to central cornea (Dis-En/Ex), and CT at incision site were quantified using AS-OCT. Results: The defective incision group showed shorter IL and larger incision angles [false discovery rate (FDR)p < 0.05]. Changes in CT at incision site were more pronounced for the defective incision group (FDRp < 0.05). Some SIA parameters were related to the certain specific CCI features, especially IL (FDRp < 0.05). Both groups exhibited significant increased 6 mm posterior corneal tHOAs at 1 month (Bonferroni correctedp < 0.01) and the defective incision group showed increased 6 mm posterior tHOAs at 6 months (Bonferroni correctedp = 0.023). There were characteristic correlations between Zernike terms and CCI features including IL, CT, Dis-En/Ex, and incision angles at 1 month, especially over 6 mm zone. Conclusion:The CCI deformities can affect corneal recovery and induce more HOAs at 1 month postoperatively. Such effects became minor, but could persist until 6 months. The IL combined with Angle-En/Ex was important factor influencing CCI integrity and corneal optical quality.

Long Term Evaluation of Surgically Induced Astigmatism and Corneal Higher-Order Aberrations After 2.2 Mm Clear Corneal Incisions in Femtosecond Laser-Assisted Cataract Surgery: Temporal versus Superior Approach

“…In the early postoperative period, it is reasonable to speculate that changes were associated with significant corneal edema at central cornea and incision site. 12 Factors, including the surgical incision, intraoperative flushing, and eyedrop administration, can also cause short-term ocular surface damage and thus affect corneal HOAs. 6 Meanwhile, the HOAs of the superior group were higher than those of the temporal group.…”

“…Apart from astigmatism, the higher-order aberrations (HOAs) are also important for visual quality. 12 The surgical procedures, including clear corneal incision (CCI), phacoemulsification, stromal hydration and intraoperative flushing, may all affect corneal regularity and consequently induce the HOAs. 12 The effect of femtosecond laser CCIs on corneal HOAs is less well know and long-term changes of corneal HOAs has not been studied so far.…”

Bibliometric analysis of research relating to refractive cataract surgery over a 20-year period: from 2003 to 2022

“…Corneal astigmatism can be corrected by the on-axis incision method in cataract surgery [25] . With the development of surgeons' techniques as well as corneal incision size, induced corneal astigmatism has been minimized [26] , which reduces the occurrence of higher-order aberrations at the same time [27] . A continuous curvilinear capsulotomy (CCC) reduces the occurrence of posterior capsule opacity, ensures the centering and stability of the IOL, and reduces the off-center and rotation of IOL, which ensures the optical effect of IOL [28] .…”

The Impact of Posterior Corneal Astigmatism on Surgically Induced Astigmatism in Cataract Surgery

“…SIA can vary under different conditions, including incision structure, length, position, impermeability, individual biomechanical differences in cornea, and surgeons' habits. [10][11][12] For a 2.2-mm clear corneal incision, SIA is reported to be 0.25 ± 0.13 D to 0.81 ± 0.54 D. 13 Therefore, understanding a surgeon's personalised centroid of the SIA is important to reduce refractive errors after toric IOL implantation.…”