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Effect of On-Axis Incision on Surgically Induced Astigmatism Following Phacoemulsification Cataract Surgery
Sadia Humayun1, Amna Tariq1, Samar Fatima1
1Department of Eye, Combined Military Hospital, Lahore, Pakistan.
Summary
A 2.75-mm on-axis limbal incision during cataract surgery results in low surgically induced astigmatism (SIA) and a significant reduction in corneal astigmatism. This method improves visual acuity and offers a practical approach to astigmatism management.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Cataract Surgery
Background:
- Phacoemulsification is a common cataract extraction technique.
- Managing astigmatism during cataract surgery is crucial for visual outcomes.
- On-axis incisions are explored for their effect on astigmatism.
Purpose of the Study:
- To determine the surgically induced astigmatism (SIA) from a 2.75-mm on-axis limbal incision.
- To evaluate the flattening effect of this incision on corneal curvature.
- To assess the impact on visual acuity after phacoemulsification.
Main Methods:
- A quasi-experimental study involving 142 eyes undergoing phacoemulsification with a 2.75-mm on-axis limbal incision.
- Keratometric readings were taken pre- and post-operatively (6 weeks) using an optical biometer.
- Surgically induced astigmatism (SIA) was calculated, and visual acuities were analyzed.
Main Results:
- Preoperative astigmatism averaged 0.88 D, decreasing to 0.65 D postoperatively (p < 0.001).
- The mean SIA was 0.58 D, with a mean reduction in astigmatism of 0.23 D.
- Both uncorrected and corrected distance visual acuity improved significantly (p < 0.001), with ~70% gaining 3+ lines.
Conclusions:
- A 2.75-mm on-axis limbal incision during phacoemulsification yields low and predictable SIA.
- This technique significantly reduces corneal astigmatism and enhances visual acuity.
- It presents a practical, cost-neutral strategy for astigmatism management in cataract surgery.
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