Comparison of surgically induced astigmatisms after clear corneal incisions of different sizes

This study was performed to assess efficiency and stability of astigmatic change by incision size after cataract surgery.

This work was designed as a retrospective, comparative, nonrandomized interventional study. A total of 121 cases of cataract surgery were reviewed in 98 patients performed by one surgeon at the Oregon Eye Institute in Eugene, OR, USA with 3-year follow-ups. All procedures were performed with the temporal approach of self-sealing incisions. The serial change in surgically induced astigmatisms were examined in all cases of three groups: Group A, cartridge injection of a foldable IOL through a 2.5 mm self-sealing incision; Group B, cartridge injection of a foldable IOL through a 3.0 mm self-sealing incision; Group C, cartridge injection of a foldable IOL through a 3.5 mm self-sealing incision. Keratometric data were obtained preoperatively, and 3 weeks, 3 months, 6 months, 9 months, 12 months, 24 months and 36 months postoperatively. Polar value analysis was performed to calculate the surgically induced astigmatism.

The astigmatic change decreased over time in Group B (P<0.05). The other groups tended to remain in induced astigmatism. All groups showed anticlockwise torque at 3 weeks following surgery. Group B showed a decrease in deviation, but the other groups showed increases in their torque value at postoperative 12 months (P<0.05).

The 3.0 mm incision size correlated with the least surgically induced astigmatism.