Effect of incision size on early postoperative visual rehabilitation after cataract surgery and intraocular lens implantation

Abstract

One hundred fifty-one unilateral cataract patients were randomly assigned to receive either a one-piece Staar AA-4203 silicone intraocular lens inserted through a 3.5 mm incision, an loptex 5 mm x 6 mm oval optic lens inserted through a 5.5 mm incision, or an AMO three-piece modified C-loop 6.0 round optic poly(methyl methacrylate) lens inserted through a 6.5 mm incision. Follow-up was 97% at two days postoperatively and 84% at one week and two months postoperatively. At one week postoperatively, 62% of 3.5 mm incision cases had uncorrected visual acuity of 20/40 or better compared with 33% of 5.5 mm (P < .01) and 43% of 6.5 mm incision cases. At two months postoperatively, 85% of 3.5 mm incision cases had uncorrected visual acuity of 20/40 or better compared with 64% of 6.5 mm (P < .05) and 71% of 5.5 mm incision cases. The 3.5 mm incision cases had significantly less total keratometric cylinder than other cases at all postoperative examinations (P < or = .001) and less surgically induced cylinder at two days and one week post-operatively (P < or = .02). The 5.5 mm and 6.5 mm incision cases did not differ significantly in visual acuity or astigmatism at any examination.

Induced astigmatism after 4 and 6 mm scleral tunnel incision

“…R small cataract incisions with foldable implants reduce the surgically induced astigmatism and produce rapid visual rehabilitation as compared to larger incisions with conventional implants Steinert et al 1991;el Maghraby et al 1993;Leen et al 1993). Small incisions and foldable implants may thus be an important tool in the prevention of significant postoperative astigmatism in patients with minimal pre-existing astigmatism.…”

Microincisional cataract surgery and Thinoptx rollable intraocular lens implantation

“…At 6 months postoperatively, 55 eyes (61.11%) had UCVAs equal to or better than 0.8 and 83 eyes (92.22%) had BSCVAs equal to or better than 0.8 according to the Snellen chart (Figs. 4,5).…”

“…xAchieving emmetropia has been a major concern with the advent of preoperative intraocular lens (IOL) power calculation formulas [10,11,16,17]. Prevention of postoperative, surgically induced corneal astigmatism is another aspect of better visual quality after cataract operations [5,12]. The promising introduction of cataract surgery through corneal microincisions now seems to achieve this aim [1].…”

Advancing microsurgical instrumentation into the 21st century

“…As a consequence, ophthalmology is exposed to rapid developments in the areas of surgical techniques, biomaterials, and ‘high tech’ instrumentation. For example, in the field of cataract surgery, the advances in the technique over the past 30 years have come about through a combination of the application of the phacoemulsification technique1 and small incision surgery,2 3 along with intensive research and development of better biomaterials 4. These innovations continue through researchers striving for even smaller incision cataract surgery5 6 and the application of laser phacolysis 7-9.…”