Background: Today, cataract surgeries are aiming pseudophakic emmetropia, which makes eliminating post-operative astigmatism must. Phacoemulsification can be done with superior, oblique, or temporal clear corneal incision (CCI), which affects post-operative astigmatism.
Objectives: The aim of this study is to compare astigmatism after superotemporal incision (STI) in the right eye and superonasal incision (SNI) in the left eye with superior incision (SI) in clear corneal phacoemulsification.
Materials and Methods: This prospective study includes 90 patients, having CCI phacoemulsification with foldable intraocular lens between October 2014 and December 2015, divided into three groups, each having 30 patients, on the basis of the type of incision in SI, STI in the right eye, and SNI in the left eye. Astigmatism was measured by Bausch and Lomb manual keratometer before surgery, on 1st, 4th, and 6-8th weeks post-operatively. All patients were astigmatically neutral pre-operatively.
Results: SI, STI, and SNI-induced post-operative astigmatism was against-the-rule (ATR) and was 66.7%, 53%, and 50% in SI, STI, and SNI groups, respectively. This showed no statistical significant (P < 0.05) indicating that horizontal component of surgically induced astigmatism (SIA) becomes steeper due to corneal healing. Mean total astigmatism was lower in STI group than SI and SNI. 93%, 73.4%, and 63.3% patients in STI, SI, and SNI groups had uncorrected visual acuity (UCVA) of ≥20/60, respectively (P > 0.05), suggesting statistical significant difference indicating better UCVA in STI group due to less SIA. Best-corrected visual acuity (BCVA) of all patients was 20/20.
Conclusion: There is no statistically significant difference in SIA among SI, STI, and SNI. However, better UCVA obtained in STI.
Key words: Phacoemulsification; Clear Corneal Incision; Surgically Induced Astigmatism
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