Correction of pre-existing astigmatism during cataract surgery: comparison between the effects of opposite clear corneal incisions and a single clear corneal incision

Simon, Guy J. Ben; Desatnik, Howard

doi:10.1007/s00417-004-1035-3

Cited by 30 publications

(27 citation statements)

References 23 publications

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“…Clear corneal incisions are invasive and produce a stable flattening effect over the long term, 17 and OCCIs have an enhanced effect. 19 In earlier studies of OCCIs, [19][20][21][22] the mean reduction in corneal astigmatism ranged from 0.50 to 2.06 D. Our study concurs with these observations. We saw a mean corneal 20 The mean SIA was 1.66 D in our OCCI group.…”

Section: Discussionsupporting

confidence: 95%

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Corneal astigmatism correction with opposite clear corneal incisions or single clear corneal incision: Comparative analysis

Khokhar

Lohiya

Murugiesan

et al. 2006

Journal of Cataract and Refractive Surgery

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Section: Discussionsupporting

confidence: 95%

“…17,18 Performing an additional CCI opposite the first CCI to enhance the flattening effect has been reported. [19][20][21][22] This method is called paired opposite clear corneal incisions (OCCIs). We performed a comparative evaluation of surgically induced astigmatism between 3.2 mm OCCI and CCI in cataract patients.…”

mentioning

confidence: 99%

Corneal astigmatism correction with opposite clear corneal incisions or single clear corneal incision: Comparative analysis

Khokhar

Lohiya

Murugiesan

et al. 2006

Journal of Cataract and Refractive Surgery

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“…However, recent designs have overcome this problem and have excellent stability (!4 degrees rotation). 28 In earlier studies of OCCIs, the mean reduction in corneal astigmatism ranged from 0.50 to 2.06 D. [29][30][31][32][33] Mean symmetrically induced astigmatism of 2.25 D was reported by Lever and Dahan, 29 2.10 D by Qammar and Mullaney, 30 1.66 D by Ben Simon and Desatnik, 31 1.75 D by Tadros et al, 32 and 1.60 D by Khokhar et al 33 Differences between studies are the result of the variety of incision lengths and the amount and type of preexisting astigmatism. In a scatter graph of astigmatism changes in our study, there was a more concentrated data set around the origin of the graph postoperatively, indicating better correction of astigmatism; the data were more concentrated in the toric IOL group.…”

Section: Discussionmentioning

confidence: 98%

“…[29][30][31][32] The incisions, which are placed on the steep corneal meridian and symmetrically opposed, are designed to flatten the steep meridian. A single clear corneal incision (CCI) will have a local flattening effect on the cornea depending on its location, width, and structure.…”

mentioning

confidence: 99%

Toric intraocular lens versus opposite clear corneal incisions to correct astigmatism in eyes having cataract surgery

Mendicute¹,

Irigoyen²,

Ruiz³

et al. 2009

Journal of Cataract and Refractive Surgery

155

111

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“…This has a larger effect than a single clear corneal incision and can correct more than one dioptre of corneal astigmatism. 13,14 Limbal relaxing incisions, otherwise known as peripheral corneal relaxing incisions, can also be used to correct astigmatism intraoperatively. This technique requires two additional incisions placed in the peripheral cornea along the steepest meridian.…”

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confidence: 99%

Surgical correction of astigmatism during cataract surgery

Buckhurst

Wolffsohn

Davies

et al. 2010

Clinical and Experimental Optometry

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High levels of corneal astigmatism are prevalent in a significant proportion of the population. During cataract surgery pre-existing astigmatism can be corrected using single or paired incisions on the steep axis of the cornea, using relaxing incisions or with the use of a toric intraocular lens. This review provides an overview of the conventional methods of astigmatic correction during cataract surgery and in particular, discusses the various types of toric lenses presently available and the techniques used in determining the correct axis for the placement of such lenses. Furthermore, the potential causes of rotation in toric lenses are identified, along with techniques for assessing and quantifying the amount of rotation and subsequent management options for addressing postoperative rotation. Correcting corneal astigmatism during cataract surgery can increase spectacle independence. For the patient, this has economic benefits 4 as well as desirable cosmetic and practical advantages. Spectacle correction of astigmatism creates meridional magnification, which when coupled with the associated back vertex distance produces retinal images that are asymmetrically magnified and distorted. Such images have been reported to reduce spatial perception 5 and adaptation to them is particularly challenging for elderly individuals, 6 in whom cataracts are more prevalent. Contrary to this, if corneal astigmatism is corrected at the corneal or intraocular lens (IOL) plane, then no significant meridional magnification is induced due to a negligible vertex distance. 7The effect of clear corneal incisions (CCIs) on surgically-induced astigmatism has been extensively examined. If placed along the steep corneal axis, the clear corneal incisions flatten the cornea, reducing the residual astigmatism. The larger the clear corneal incision, the greater the flattening effect. 8 Studies have shown that the average surgically induced astigmatism using a 3.0 to 3.2 mm clear corneal incision is~0.50 D.9,10 The temporal cornea allows easy access for incisions and is the preferred site of most surgeons, 11 however, incisions performed on the steepest axis result in superior postoperative uncorrected vision.12 Opposite clear corneal incisions require a second clear corneal incision to be placed along the steep axis of the cornea on the opposing side of the pupil. This has a larger effect than a single clear corneal incision and can correct more than one dioptre of corneal astigmatism.13,14 Limbal relaxing incisions, otherwise known as peripheral corneal relaxing incisions, can also be used to correct astigmatism C L I N I C A L A N D E X P E R I M E N T A LOPTOMETRY

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Correction of pre-existing astigmatism during cataract surgery: comparison between the effects of opposite clear corneal incisions and a single clear corneal incision

Cited by 30 publications

References 23 publications

Corneal astigmatism correction with opposite clear corneal incisions or single clear corneal incision: Comparative analysis

Corneal astigmatism correction with opposite clear corneal incisions or single clear corneal incision: Comparative analysis

Toric intraocular lens versus opposite clear corneal incisions to correct astigmatism in eyes having cataract surgery

Surgical correction of astigmatism during cataract surgery

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