[7 mm tunnel incision with lateral approach as routine intervention in cataract surgery]

As the lateral incision in comparison to the classic incision at the 12 o'clock position induces less astigmatism and shows higher wound stability, we wanted to determine if this technique could be used as a routine procedure for most patients.

A total of 186 patients were prospectively included in this study. They all had a lateral incision with the no-stitch technique, either as a clear corneal incision or as a corneoscleral or scleral incision. Postoperatively, patients were followed up for up to 12 months.

Whereas the scleral incision showed the highest wound strength, one patient with a corneoscleral incision needed a later suture. There were two cases of endophthalmitis after a clear corneal incision; 6-12 months postoperatively the mean induced astigmatism amounted 0.64 +/- 0.22 D after a scleral incision, 0.71 +/- 0.47 D after a corneoscleral incision, and 0.92 +/- 0.63 D after a clear corneal incision.

The lateral approach with a scleral is a safe procedure and induces very little astigmatism. It can be used routinely for all patients who have inverse preoperative astigmatism or none at all. The clear corneal incision shows instable wound closure and a higher infection risk. In the long term it induces an astigmatism of about 1 D and therefore is of no use for correction of higher inverse astigmatism.