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Keratometric astigmatism after cataract surgery using small self-sealing scleral incision
1Department of Ophthalmology, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kweishan, Taoyuan, Taiwan, R.O.C.
Background:
To evaluate the corneal refractive changes after a small self-sealing scleral wound.
Methods:
A 4 mm self-sealing scleral tunnel incision and implantation of a foldable intraocular lens were adopted during phacoemulsification. A retrospective review of 48 consecutive isolated eyes in 48 patients was performed to assess the postoperative corneal refractive change. Keratometric readings were recorded for 3 months following surgery.
Results:
At one week postoperatively there was a -0.29 +/- 1.02 (standard deviation) change of Naeser's polar value (against-the-rule shift) in the cylinder keratometry. The cylinder had with-the-rule shift and recovered to the preoperative state at one month postoperatively. The change of Naeser's polar value at the third postoperative month was 0.05 +/- 0.80 (with-the-rule shift) compared with the preoperative polar value. The change of astigmatism at the third postoperative month was -0.38 +/- 0.74 (Diopters) using simple subtraction and -1.01 +/- 0.58 (Diopters) using the Jaffe vector analysis. The axis of astigmatism exhibited a mild against-the-wound shift at 1 week and a gradual with-the-wound shift afterwards.
Conclusion:
The low induced astigmatism, early recovery of corneal curvature and no direct damage to the cornea support the concept and justify the use of a small self-sealing scleral tunnel incision during cataract surgery.