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E. Borasio, J. Mehta, M. Tacker, V. Maurino; Astigmatism Axis Shift After Sutureless Phacoemulsification: Comparison Between Clear–Corneal Temporal and Clear–Corneal On–Axis Incision . Invest. Ophthalmol. Vis. Sci. 2005;46(13):780.
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Purpose: To compare the shift in corneal astigmatism axis before and after phacoemulsification between eyes receiving either Temporal (CCT) or On–axis clear–corneal incision (CCOA). Methods: RCCT involving 62 eyes with cataract and corneal astigmatism (ranging from 0.75 to 2.5 D) undergoing phacoemulsification (single surgeon), randomized to receive either CCT or CCOA incision. Corneal astigmatism was assessed pre– and post–operatively with corneal topography. The axis of the incisions was marked preoperatively to avoid anaesthesia related cyclotorsion. The shift of the axis of the astigmatism was assessed three weeks after surgery. Results: At three weeks, axis shifts > 30° occurred in 38,7% of eyes receiving the On–axis incision and only in 15,6% of the ones receiving the Temporal incision. Differences were statistically significant (p<0,05). Conclusions: The Temporal clear–corneal incision caused significantly less corneal axis shift compared to the On–axis incision. The flattening induced by the on–axis incision frequently occurred on an unexpected corneal meridian. This should be taken into account when aiming at reducing the pre–operative astigmatism in cataract surgery by placing the incision on the steepest meridian.
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