A COMPARISON OF SURGICALLY-INDUCED ASTIGMATISM BETWEEN PHACOEMULSIFICATION WITH SUPERIOR INCISION AND SMALL INCISION CATARACT SURGERY WITH STEEP AXIS INCISION
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 4
Abstract
BACKGROUND The recent years have seen a huge increase in the burden of cataract surgery in India along with a decreased tolerance for spectacles in patients after cataract surgery. These changing trends have made it essential for each surgeon to strive for the ultimate goal of postoperative emmetropia by minimising the Surgically-Induced Astigmatism (SIA). One of the main factors influencing SIA is the type of cataract surgery due to the differences in their incision size. Presently, both Small Incision Cataract Surgery (SICS) and phacoemulsification are widely practised all over our country. Such a scenario makes it relevant to compare the two surgeries and adopt the one with better visual outcome in order to keep up with patient expectations. In our study, we aimed to compare the magnitude of postoperative SIA and Best Corrected Visual Outcome (BCVA) between SICS and phacoemulsification. Moreover, while all phaco surgeries were performed using a superior clear corneal incision, all SICS cases used an incision on the steeper axis. MATERIALS AND METHODS 300 operable cataract patients (<grade 3 nuclear sclerosis) with preoperative astigmatism less than 3D were divided into two groups of 150 patients each. Group A underwent phacoemulsification with superior clear corneal incision, while group B underwent SICS with incision along the steeper meridian. BCVA and keratometry were measured 12 weeks after surgery. The keratometry values were inputted into SIA calculator (version 2.1) and the resultant SIA was found. RESULTS The mean SIA in group A (0.7793 ± 0.445) was significantly less (p<0.0001) than that in group B (1.6887 ± 1.473). The postoperative BCVA was also significantly better (p<0.0001) in group A than in group B. Moreover, the SIA was independent of the age of the patient, but was significantly correlated with the BCVA. The more the postoperative SIA, the poorer was the BCVA. CONCLUSION Even when the incision is made in the steeper meridian in SICS, it induces significantly more astigmatism than phacoemulsification with superior incision.
Authors and Affiliations
Subhra Sarkar, Adwaita Nag, Sreya Biswas, Gaurav Chauhan
Keywords
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- EP ID EP450826
- DOI 10.18410/jebmh/2018/62
- Views 89
- Downloads 0
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