CUTTING EDGE: HOW INCISION SIZE INFLUENCES CORNEAL HYSTERESIS IN CATARACT

To evaluate the effects of incision size (2.4 mm versus 2.7 mm) on corneal hysteresis (CH), intraocular pressure (IOP), refractive outcomes, and corneal thickness in patients undergoing cataract surgery.

Policlinico G. Martino Messina Italy. The study involved 140 eyes undergoing phacoemulsification, divided into two groups: one with 2.4 mm incisions and the other with 2.7 mm incisions. Preoperative evaluations confirmed normal corneal thickness, averaging 550 micrometers (μm).

The methods included measuring corneal thickness with Pentacam and assessing CH and IOP preoperatively and postoperatively. In total, 70 eyes were in the 2.4 mm group, while 70 were in the 2.7 mm group.

The results indicated minimal changes in corneal thickness postoperatively, with averages of 549 μm for the 2.4 mm group and 547 μm for the 2.7 mm group. Corneal hysteresis increased significantly in the 2.4 mm group, from 9.5 to 10.2 mmHg, compared to a modest increase in the 2.7 mm group, from 9.3 to 9.6 mmHg. Intraocular pressure decreased more in the 2.4 mm group, from 15.2 to 14.5 mmHg, than in the 2.7 mm group, which decreased from 15.5 to 15.0 mmHg. Additionally, refractive outcomes showed a higher prevalence of myopia in the 2.4 mm group.

In conclusion, the findings suggest that smaller incisions (2.4 mm) enhance corneal hysteresis, manage intraocular pressure more effectively, and improve visual outcomes in cataract surgery. Tailored surgical approaches may optimize results based on incision size.