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H. L. Oliveira Neto, I. Cardoso Neto, R. F. Reis, J. Bessa Jr; Surgically-Induced Astigmatism in Phacoemulsification: 2.2mm versus Eleven Scalpel Blade Clear Corneal Incisions. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5396.
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© ARVO (1962-2015); The Authors (2016-present)
To compare clinical outcomes of coaxial small incision (2.2 mm) and coaxial standard convencional blade clear corneal cataract surgerySetting: UEFS-CLIHON Day Hospital, Feira de Santana-Bahia, Brazil
In a retrospective trial, 39 eyes with cataract and mild to moderate corneal astigmatism (1.35±0.75 D on IOL master keratometry) undergoing phakoemulsification were randomized to receive coaxial surgery with 2.2 mm (group 1) or eleven scalpel blade (group 2) 2.1 to 2.3 mm corneal incisions. Main outcome measures were postoperative BCVA, corneal and refractive astigmatism, and Surgically-induced astigmatism (SIA); calculated using the Unpaired T test analysis method. Thirty seven eyes made it to the post-operative assessment at 4 and two eyes at 6 months, where they all underwent refraction, IOL master keratometry, and clinical examination.
At 4 weeks follow up, the mean SIA in group 1 was -0.33±0.72 D (standard deviation 0.72) and -0.13±0.35 D (standard deviation 0.35) in group 2. Statistical analysis of our results using unpaired t-test revealed that the difference between the two groups was not significant (95% confidence Interval). The average line gain of LogMAR visual acuity was 0.41 in group 1, and 0.39 in group 2. Again, the difference in the amount of BCVA gained between the 2 groups was not statistically significant (p<0.05)
There is a movement underway to choose the smallest incision and type of knife in cataract surgery in order to minimize the amount of surgically induced astigmatism. However, in our study, we found the difference in the value of SIA to use 2.2 mm vs eleven scalpel blade clear corneal incisions is statistically insignificant.
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