Intraoperative arcuate transverse keratotomy with phacoemulsification

Area of Science:

• Ophthalmology
• Surgical Techniques
• Refractive Error Correction

Background:

• Pre-existing astigmatism is a common complication in cataract surgery.
• Phacoemulsification with a clear corneal tunnel is a standard cataract surgery technique.
• Astigmatism correction during cataract surgery can improve visual outcomes.

Purpose of the Study:

• To evaluate the efficacy of intraoperative arcuate transverse keratotomy combined with phacoemulsification in correcting pre-existing astigmatism.
• To compare the outcomes of combined arcuate keratotomy and phacoemulsification versus phacoemulsification alone.

Main Methods:

• A prospective randomized case-control study involving 34 eyes of 28 patients with immature senile cataract.
• Patients were divided into two groups: one receiving arcuate keratotomy with phacoemulsification and a control group receiving phacoemulsification alone.
• Outcomes including keratometric astigmatism, surgically induced refractive changes, and coupling ratio were assessed at 1 day, and 1, 4, and 8 weeks postoperatively.

Main Results:

• The arcuate keratotomy group showed a mean reduction in keratometric astigmatism of 1.26 D compared to 0.48 D in the control group (P = .0296).
• Surgically induced refractive change was 2.15 D in the keratotomy group versus 1.50 D in the control group (P = .046).
• The coupling ratio was -1.10 in the keratotomy group and -0.82 in the control group at 8 weeks.

Conclusions:

• Combining intraoperative arcuate keratotomy with steep axis phacoemulsification incision is more effective in reducing pre-existing astigmatism.
• This combined approach offers a significant advantage over phacoemulsification alone for astigmatism correction.
• The findings support the use of arcuate keratotomy as an adjunct to phacoemulsification for managing astigmatism in cataract surgery.