Temporal versus superior approach phacoemulsification: short-term postoperative astigmatism

Area of Science:

• Ophthalmology
• Surgical Techniques
• Cataract Surgery

Background:

• Phacoemulsification is a common cataract surgery technique.
• Incisions in cataract surgery can influence postoperative astigmatism.
• Comparing different incision types is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To compare short-term clinical outcomes of temporal clear corneal phacoemulsification with a 5.2 mm incision versus superior corneoscleral phacoemulsification.
• To evaluate postoperative astigmatism and uncorrected visual acuity at 2 months.
• To assess the impact of incision location on surgically induced astigmatism (SIA).

Main Methods:

• Prospective clinical trial involving 80 patients with senile cataract.
• Random assignment to either a temporal clear corneal or superior corneoscleral approach for phacoemulsification.
• Surgically induced astigmatism (SIA) calculated using Naeser's polar value method.

Main Results:

• Significant differences in SIA between groups (P < .001), with temporal approach causing with-the-rule (WTR) astigmatism and superior approach causing against-the-rule (ATR) astigmatism.
• No other statistically significant differences in clinical outcomes were observed between the groups (P < .05).
• A trend towards better uncorrected visual acuity in the temporal group at 2 weeks was not statistically significant (P = .562).

Conclusions:

• No-stitch, temporal, 5.2 mm clear corneal phacoemulsification yields results comparable to the superior corneoscleral approach.
• The temporal approach induces WTR astigmatism, while the superior approach induces ATR astigmatism.
• Further research with larger patient cohorts is recommended to validate these findings.