Comparison of Surgically Induced Astigmatism L-Shaped vs Straight Incisions in Manual Small Incision Cataract Surgery
Article Sidebar
-
Astigmatism, Emmetropia, Straight incision, L-shaped incision, Cataract
Abstract
Aims and objective: To compare surgically induced astigmatism(SIA) in L-shaped vs straight incision in manual small incision cataract surgery(SICS).
Material method: 60 patients aged 35 years and above with uncomplicated cataract with nuclear sclerosis of any grade were included in the study who were divided into 2 groups randomly. 30 patients underwent SICS with straight scleral incision and 30 with L-shaped incision. Data was analyzed using SPSS version 15.0 statistical analysis and calculations were performed using SIA calculator version 2.1.
Results: The SIA (surgically induced astigmatism) was 1.14 ± 0.44D, 0.81 ± 0.40D, 0.61 ± 0.33 D on 1st post-operative day, 4 weeks and 6 weeks respectively in straight incision group and the SIA was 0.79 ± 0.36D, 0.33 ± 0.31D, 0.15 ± 0.18D on 1st post-operative day, 4 weeks and 6 weeks respectively in L-shaped incision group.
Conclusion: L-shaped incision technique induces less amount of SIA as compared to straight incision and the difference is statistically significant. Also, L-shaped incision maintains better anterior chamber stability and leads to early visual rehabilitation. In poor and developing countries where still majority of cases are being operated by manual SICS, achieving emmetropia or minimal refractive errors should be the goal.
Full text article
References
Venkatesh R, Tan C.S.H, Sengupta S, Ravindran R.D, Krishnan K.T, Chang D.F. Phacoemulsification versus manual small-incision cataract surgery for white cataract. J Cataract Refract Surg 2010;36:1849-54.
Roman SJ, Auclin FX, Chong-Sit DA, Ullern MM. Surgically induced astigmatism with superior and temporal incisions in cases of with-the-rule preoperative astigmatism J Cataract Refract Surg. 1998;24:1636-44.
Gills JP, Sanders DR, editors. Small incision cataract surgery; Foldable lenses, One- stitch surgery, Sutureless surgery, Astigmatic keratotomy.Thorofare, NJ; Slack; 1990;147-50.
Singer JA.Straight incision for minimising induced astigmatism after small incision cataract surgery with rigid optic intraocular lens implantation. J Cataract Refract Surg 1991;17:677-688.
Hennekes RL, Van den Dooren KA.Asymmetric L-shaped corneal no-stitch tunnel incisions for cataract surgery. J Cataract Refract Surg. 1999;25(4):550-55.
Basak SK, Basaka S, Chowdhury AR. 'SIA-Soft': a new software to calculate surgically induced astigmatism in comparison with manual mathematics by vector method. Indian J ophthalmol. 2008;56(2):170.
Narang P, Agarwal A.L-shaped scleral incision may be ideal for IOL explantation, insertion. Ocular Surgery News U.S. Edition, January 10, 2016.
Tetiko?lu M, Yeter C, Helvac?o?lu F, Akta? S, Sa?d?k HM, Özcura F.Effect of Corneal Incision Enlargement on Surgically Induced Astigmatism in Biaxial Microincision Cataract Surgery.Turk J Ophthalmol. 2016; 46(3):99-103.
Edmund A, Ahmed A, David B, Eugene A, Felix A, Frank Y et al.Postoperative Corneal and Surgically Induced Astigmatism following Superior Approach Manual Small Incision Cataract Surgery in Patients with Preoperative Against-the-Rule Astigmatism. J Ophthalmol. 2016;2016: 9489036.
Akura J, Kaneda S, Hatta S, Matsuura K. Controlling astigmatism in cataract surgery requiring relatively large self-sealing incisions. J Cataract Refract Surg.2000; 26:1650-9.
Jauhari N., Chopra D., Chaurasia R. K., Agarwal A. Comparison of surgically induced astigmatism in various incisions in manual small incision cataract surgery. Internat J Ophthalmol.2014;7(6):1001-1004.
Megbelayin E.Wound geometry as it relates to tunnel valvular competence in manual small incision cataract surgery. Niger J Ophthalmol 2014; 22(1):1-6.
SS Haldipurkar, Hasanain T, Vishwanath G. Wound construction in manual small incision cataract surgery. Indian J Ophthalmol. 2009;57(1): 9-13.
Giansanti F, Rapizzi E, Virgili G, Mencucci R, Bini A, Vannozzi L et al.Clear corneal incision of 2.75 mm for cataract surgery induces little change of astigmatism in eyes with low preoperative corneal cylinder. Eur J Ophthalmol. 2006;16(3):385-93.
Gokhale NS, Sawhney S. Reduction in astigmatism in manual small incision cataract surgery through change of incision site. Indian J Ophthalmol. 2005;53(3):201-3.
Kohnen T, Lambert, R.J., Koch, D.D. Incision sizes for foldable intraocular lenses. Ophthalmology.1997;104:1277-86.
Authors
Copyright (c) 2022 Rohini Choudhary
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
