Effect of Corneal Incision Enlargement on Surgically Induced Astigmatism in Biaxial Microincision Cataract Surgery

Abstract

Objectives:To evaluate surgically induced astigmatism (SIA) in biaxial microincision cataract surgery with enlargement of one corneal incision during intraocular lens implantation (IOL).Materials and Methods:Data from 683 eyes with cataract that underwent biaxial microincision cataract surgery and IOL were retrospectively analyzed. The operated eyes were divided into 4 groups defined by final corneal incision length after IOL implantation. There were 83 eyes with 1.6 mm corneal incisions (group 1) and 200 eyes in each of the 2, 2.4, and 2.8 mm corneal incision groups (groups 2, 3 and 4, respectively). SIA was assessed using preoperative and postoperative keratometric values at one month.Results:The mean magnitude of SIA was 0.83±0.4 D in group 1, 0.93±0.5 D in group 2, 1.03±0.6 D in group 3 and 1.04±0.7 D in group 4. The SIA showed statistically significant differences between the four groups (p=0.05). Pairwise group comparisons revealed significant differences between groups 1 and 3 and groups 1 and 4 (p=0.005).Conclusion:Biaxial microincision cataract surgery with an incision size of 1.6 mm resulted in the least SIA. Enlargement of the corneal incision beyond 2.0 mm during IOL implantation led to significant increases in SIA. We believe that with the development and dissemination of IOLs which can be inserted through small corneal incisions, biaxial microincision cataract surgery will be the best choice to prevent SIA and increase visual acuity.

Preliminary clinical study of LenSx femtosecond laser-assisted limbal relaxing incision on correction of high myopia with low to moderate astigmatism in posterior implantable collamer lens implantation

“…It is considered that during long-term corneal incision healing in the LenSx + ICL group, the diopter of the astigmatism is increased, which indicates astigmatism regression and thus may result in a slight decrease in visual acuity and visual quality. This is consistent with the research by Tetikoğlu [16], which found that the healing process of surgical incision directly affects the corneal astigmatism and thus affects the change in corneal aberration.This also suggests us that we can further explore the problem of astigmatism regression caused by corneal incision healing, and adjust the nomogram so as to obtain a more stable and longer-term astigmatism correction effect.In recent years, refractive surgeons have aimed not only to improve the visual acuity of the patient but also to improve the patients' visual quality through a series of personalized operations. Myopia and astigmatism are low-order aberrations (LOAs) and cannot truly re ect the visual quality of patients.…”

Preliminary Clinical Study of a LenSx Femtosecond Laser-Assisted Limbal Relaxing Incision for the Correction of High Myopia with Low to Moderate Astigmatism in Posterior Implantable Collamer Lens Implantation

“…It is considered that, during long-term corneal incision healing in the LenSx + ICL group, the diopter of the astigmatism is increased, indicating astigmatism regression and thus a possible slight decrease in visual acuity and visual quality. is outcome is consistent with the research by Tetikoglu [14], which found that the healing process of the surgical incision directly affects corneal astigmatism and thus affects the change in corneal aberration. It also suggests that we can further explore the problem of astigmatism regression caused by corneal incision healing and adjust the nomogram to obtain a more stable and longer-term astigmatism correction effect.…”

Comparison of incision size and intraocular lens performance after implantation with three preloaded systems and one manual delivery system

“… 23 Tetikoğlu et al evaluated the effect of incision enlargement on rates of SIA after biaxial phacoemulsification and found that there is a significant increase in SIA as incision size increased from 2.0 to 2.8 mm. 7 …”