Evaluation of Opposite Clear Corneal Incision in Controlling Astigmatism in Cataract Patients Undergoing Phacoemulsification Surgery

Bhalla, Jatinder Singh

doi:10.7869/djo.182

Cited by 3 publications

(5 citation statements)

References 23 publications

(31 reference statements)

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“…In the study, astigmatism reduction was found to be statistically significant in both WTR and ATR groups ( P < 0.001). However, there was no significant difference in preoperative astigmatism reduction between the two groups, 21 which is not consistent with the present study conducted by our clinicians.…”

Section: Discussioncontrasting

confidence: 90%

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Paired Opposite 4 mm Clear Corneal Incisions on Steep Meridian during Phacoemulsification

2021

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Purpose: To evaluate the effect of opposite clear corneal incisions (OCCI) with 4 mm incisions on the steep meridian on postoperative astigmatism. Methods: This study was performed on 64 eyes of 55 patients with keratometric astigmatism of ≥ 1 diopter (D) undergoing phacoemulsification. Patients were divided into two groups, with-the-rule (WTR) astigmatism and against-the-rule (ATR) astigmatism. Initial incisions in the WTR group were performed on the temporal side with 3.2 mm keratome and paired stab incisions were performed on the steep meridian. At the end of the surgery, stab incisions were enlarged to 4 mm. Follow-up visits were scheduled at 1, 3, 6, and 12 months postoperatively, which included refraction and keratometry. Results: It was found that the mean preoperative keratometric astigmatism was 2.06 ± 0.86 D. The postoperative mean keratometric astigmatism was 1.3 ± 0.7 D after 1 month and 1.2 ± 0.7 D after 12 months. The mean astigmatism correction between the preoperative measure and that taken at 1 month was statistically significant ( P = 0.001), but there was no significant change in the severity of astigmatism afterward. The mean surgically-induced astigmatism was found to be 1.99 ± 0.9 D. The 12-month changes of mean absolute astigmatism were: 1.06 ± 0.7 D in the WTR group, and 0.53 ± 0.7 D in the ATR group. The difference between the two groups was statistically significant ( P = 0.02). Conclusion: Based on our findings, we posit that paired OCCI on the steep axis, using 4 mm incisions is an effective technique to correct preoperative astigmatism.

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Section: Discussioncontrasting

confidence: 90%

“…In addition, a significant difference was found between the WTR and ATR groups in reducing the severity of astigmatism ( P = 0.02). An investigation by Bhalla et al 21 divided patients into three groups: No preoperative astigmatism, a WTR group, and an ATR group. In each patient group, there were 15 eyes.…”

Section: Discussionmentioning

confidence: 99%

Paired Opposite 4 mm Clear Corneal Incisions on Steep Meridian during Phacoemulsification

2021

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“…The mean magnitude of SIA was 0.403 AE 0.183 D in our CCI group, which was less than Khokhar's study (0.85 AE 0.75 D) 11 and Nemeth's study (0.61 AE 0.43 D) 14 but more than Bazzazi's study (0.036 AE 0.51 D) 13 and Bhalla's study (0.33 AE 0.22 D). 9 Regarding the OCCI group of our study, the mean magnitude of SIA was 0.849 AE 0.519 D, which was less than that of Lever and Dahn's study (2.25 D), 5 Tedros' study (1.57 D), 12 Qammar and Mullaney's study (2.10 D), 10 Nemeth's study (0.99 D) 14 and Khokhar's study (1.66 D). 11 On contrary, the mean SIA of our OCCI was higher than that of Bazzazi's study (0.505 D), and Bhalla's study (0.76 D).…”

Section: Discussionmentioning

confidence: 99%

“…11 On contrary, the mean SIA of our OCCI was higher than that of Bazzazi's study (0.505 D), and Bhalla's study (0.76 D). 9 All the above differences in the resulted mean change in astigmatism and SIA could be the result of using 2.8 mm incisions in our study compared to 3.2 mm incisions used in most of the studies that corrected a higher astigmatism than we did, or may be due to different sample sizes, postoperative topographic astigmatism (1.37 D in our study versus 3.6 D in other studies), and follow up period (one month versus 2-3 months in others).…”

Section: Discussionmentioning

confidence: 99%

Incisional correction of corneal astigmatism during ‎phacoemulsification – a randomized trial

et al. 2021

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Background: Phacoemulsification is regarded as a type of refractive surgery by which it is possible to ‎reduce pre-existing corneal stigmatism.‎ This study aimed to evaluate the efficacy and safety of on-axis corneal incision with or without opposite clear corneal incisions (OCCI) to correct preoperative corneal astigmatism during uncomplicated phacoemulsification ‎surgeries.‎ Methods: A randomized, prospective, parallel two-arm interventional study, which included a ‎total 40 eyes from 40 patients, was conducted.‎ Patients were divided into two groups: 20 patients as controls underwent phacoemulsification with on-axis incision (CCI group), and 20 patients underwent phacoemulsification with OCCI (OCCI group). Results: Mean astigmatic correction was significantly higher in the OCCI group (0.665 vs 0.265 diopters, p-value <0.001), compared to the CCI group. Most of the parameters (surgical induced astigmatism, magnitude of error, and correction index) were significantly higher in the OCCI group compared to the CCI group (p-value <0.01). There were no ‎incision-related complications. Conclusions: Both incisional methods are useful methods for correction of preoperative corneal ‎astigmatism but OCCIs correct a higher amount of astigmatism than the on-axis clear ‎corneal incision.‎ Registration: ClinicalTrials.gov NCT04418986 (05/06/2020).

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“…About 70% of cataract population has at least 1.00D of astigmatism & 33% of patients undergoing cataract surgery are eligible for treatment of pre-existing astigmatism. (14). Prevalence of corneal astigmatism before cataract surgery is 67.7% corneal astigmatism between 0.25 & 1.25 D, 27.5% was 1.25D or higher and 4.8% has less than 0.25 D of corneal astigmatism.…”

mentioning

confidence: 99%

Corneal incision on steepest meridian in phacoemulsification, could it correct the corneal astigmatism?

Ziada¹

2021

Preprint

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Introduction: Cataract surgery is regarded as refractive surgery when we are aiming at eliminating corneal astigmatism. So when planning a surgery both spherical and astigmatic components should be taken into account to achieve emmetropia postoperativelyPurpose: Measuring the changes of keratometric reading (K1, K2) after phacoemulsification surgery with planned incision on the steepest meridian in 50 eyes presenting as well with corneal astigmatism checking if this planned incision on steepest meridian could be an effective method or not to decrease the corneal astigmatism.Patients and Methods: A prospective study included 50 eyes of 35 patients that had immature senile cataract with corneal astigmatism more than 1 Diopter. Patients had been recruited and followed up in private eye center in Cairo. Phacoemulsification was done in all cases with placing the main clear corneal incision (0.5 mm from anatomical limbus, 2 mm tunnel length, 3 mm widths) on the steepest meridian. Follow up of patients included UCVA and BCVA at recorded 3 visits; 1 week, 1 month and 3months postoperatively, K-reading changes after 3 months postoperatively detected with pentacam, also, slit-lamp to assess both anterior and posterior segments.Results: this study showed a statistically significant change of front corneal astigmatism of 0.70 D and of 0.07 D of back corneal astigmatism.Conclusion: This method is effective in mild degree corneal astigmatism (up to 1D), while higher degree of astigmatism may need different method of intervention to be more effective in correction of astigmatism. We recommended measuring the IOL power depending on expected postoperative keratometric reading.

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Evaluation of Opposite Clear Corneal Incision in Controlling Astigmatism in Cataract Patients Undergoing Phacoemulsification Surgery

Cited by 3 publications

References 23 publications

Paired Opposite 4 mm Clear Corneal Incisions on Steep Meridian during Phacoemulsification

Paired Opposite 4 mm Clear Corneal Incisions on Steep Meridian during Phacoemulsification

Incisional correction of corneal astigmatism during ‎phacoemulsification – a randomized trial

Corneal incision on steepest meridian in phacoemulsification, could it correct the corneal astigmatism?

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