The location of incision in cataract surgery and its impact on induced astigmatism

Hashemi, Hassan; Khabazkhoob, Mehdi; Soroush, Sara; Shariati, Reyhane; Miraftab, Mohammad; Yekta, Abbasali

doi:10.1097/icu.0000000000000223

Cited by 47 publications

(42 citation statements)

References 59 publications

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“…The dorsonasal cornea is more susceptible to astigmatism as it is closer to the corneal center than the temporal limbus. This results in more dramatic changes in corneal topography when disrupted . Additionally, there is inherent difficulty for a right‐handed surgeon in accessing a cataract in the left eye through a dorsonasal incision, due to orbital conformation and nose anatomy, particularly in mesocephalic and dolicocephalic canines.…”

Section: Discussionmentioning

confidence: 99%

Surgically induced astigmatism in canines following sutured dorsonasal vs dorsotemporal clear corneal incisions

Pederson

Cleymaet

Hess

et al. 2019

Veterinary Ophthalmology

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Objectives: To investigate use of the Pentacam® HR for evaluation of surgically induced corneal astigmatism (SIA) in canines undergoing bilateral phacoemulsification and determine differences between dorsonasal and dorsotemporal clear corneal incisions. Animals: Client-owned canines undergoing bilateral phacoemulsification. Procedures: Patients received anterior segment imaging pre-operatively, immediately post-operatively, and 2-4 months post-operatively (follow-up). Total corneal refractive power was used to determine SIA. Surgically induced astigmatism was compared between right and left eyes, representing dorsotemporal and dorsonasal incisions, respectively. Repeated measures analyses were used between time points and paired t test compared SIA between eyes. Results: Complete imaging series were obtained for seven patients. Follow-up imaging occurred at a median of 112 days (range 60-132 days) post-operatively. For repeated measures analyses, significant differences were found between pre-and immediate post-operative values (P < 0.01), and between immediate post-operative and follow-up values (P < 0.01). There was no significant difference between preoperative and follow-up values. Surgically induced astigmatism was significantly different between right and left eyes, with values of 2.01 ± 1.24 D and 3.05 ± 1.58 D at 3 mm radius (P < 0.05), and 2.04 ± 1.18 D and 3.06 ± 1.27 D at 4 mm radius (P < 0.05) for dorsotemporal and dorsonasal incisions, respectively. Conclusions: Preliminary investigation revealed improvement of corneal SIA 2-4 months post-operatively, but development of significantly more SIA in dorsonasal vs dorsotemporal incisions. This prompts consideration of patient or microscope rotation to create a more dorsotemporal incision when possible. K E Y W O R D S canine, clear corneal incision, cornea, Pentacam, phacoemulsification, surgically induced astigmatism 800 | PEDERSON Et al.

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Section: Discussionmentioning

confidence: 99%

Surgically induced astigmatism in canines following sutured dorsonasal vs dorsotemporal clear corneal incisions

Pederson

Cleymaet

Hess

et al. 2019

Veterinary Ophthalmology

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“…The correlation of the incision size and surgical induced astigmatism has been of interest to ophthalmologists, and there are reports of a positive correlation. [10][11][12] However, a recent Cochrane review has suggested that there may not be a significant, consistent impact of the size of the incision of Phacoemulsification surgery on the surgically induced astigmatism or postoperative visual acuity over a longer term. The review reported that there might be less astigmatism with coaxial micro incision Phacoemulsification surgery, but even that difference was small in the range of 0.2 D with uncertain evidence.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2019

MIJOPH

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Background: Phacoemulsification cataract surgery can be done with temporal incision foldable posterior chamber intraocular lens (PCIOL) implantation. An extended temporal incision can also do it with rigid (non-foldable) intraocular lens implantation. The size of the incision may impact the magnitude of postoperative Astigmatism and visual outcome. The foldable lens requires a small incision but is expensive as compared to a rigid lens and may not be affordable for poor patients. Methods: The present prospective study was done at the Ophthalmology Department at a tertiary care centre in Maharashtra. 100 eyes of 100 patients were included in the study. Depending on the type of intraocular lens implant inserted in the eyes of the patients, they were divided into two groups irrespective of the type of astigmatism. Results: The study comprised of 100 patients with 54 males and 46 females. Mean age in group I group II was 60.68 ± 11.8 years and 63.16 ± 9.32 years respectively. Mean Surgical induced astigmatism on day 42 in group I group II was 0.56 ± 0.5 and 0.62 ± 0.6 respectively with no statistically significant difference between the two groups. Also, there was no statistically significant difference between the two groups on day 42 with respect to corrected visual acuity. Conclusions: From study results it can be concluded that there were similar results with regard to surgical induced astigmatism and corrected visual acuity after Phacoemulsification cataract surgery using foldable PCIOL and rigid PCIOL implantation. Considering the patient affordability factor, Phacoemulsification cataract surgery with rigid (nonfoldable) lens implantation can be an acceptable option.

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“…Compared with superior incisions, temporal incisions are associated with a lower level of SIA and are accordingly used for patients with low-level astig matism (16) . In our study, we used superior incisions even though our patients had a low-level astigmatism.…”

Section: Discussionmentioning

confidence: 99%

Effect of corneal biomechanical properties on surgically-induced astigmatism and higher-order aberrations after cataract surgery

Koç¹,

İlhan²,

Koban³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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The location of incision in cataract surgery and its impact on induced astigmatism

Abstract: The temporal incisions in cataract surgery are associated with little SIA and are appropriate choices for mild preoperative astigmatism. At higher levels of preoperative astigmatism, superior incisions are associated with better results when combined methods are not applied.

Cited by 47 publications

References 59 publications

Surgically induced astigmatism in canines following sutured dorsonasal vs dorsotemporal clear corneal incisions

Surgically induced astigmatism in canines following sutured dorsonasal vs dorsotemporal clear corneal incisions

Untitled

Effect of corneal biomechanical properties on surgically-induced astigmatism and higher-order aberrations after cataract surgery

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