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Opposite clear corneal incisions on the steep meridian in phacoemulsification: early effects on the cornea
Athanassius Tadros1, Maged Habib, Deepak Tejwani
1Royal Eye Infirmary, Dorset County Hospital, Dorchester, Dorset, United Kingdom. athanassius@btinternet.com
Purpose:
To evaluate the effect of on-axis opposite clear corneal incisions (OCCIs) in phacoemulsification on reducing preoperative corneal astigmatism and to predict the astigmatic outcome of the incisions.
Setting:
Royal Eye Infirmary, Dorset County Hospital, and Winterbourne Hospital, Dorchester, Dorset, and the Department of Ophthalmology, East Somerset Hospital, Yeovil, Somerset, United Kingdom.
Methods:
This prospective study included all patients (n = 103) who had on-axis OCCIs as a part of routine phacoemulsification with foldable intraocular lens (IOL) implantation performed by 1 surgeon during 2000. Keratometry was done 6 to 8 weeks postoperatively. The differences in the preoperative and postoperative corneal astigmatism and corneal spherical equivalent (SE) were recorded. Surgically induced astigmatism (SIA) was calculated using vector analysis.
Results:
The mean reduction in corneal astigmatism was 0.50 diopter (D) (P<.001). The mean SIA was 1.57 D (95% confidence interval [CI], 1.42 to 1.71). There was a weak association between the SIA and the patient's age and axis of preoperative astigmatism. The mean change in SE was +0.02 D (95% CI, -0.08 to +0.12).
Conclusions:
Results indicate that on-axis OCCIs are a reliable and practical way of reducing preexisting corneal astigmatism. The change in SE was negligible and thus can be ignored during biometry.
