COMPARATIVE EVALUATION OF ASTIGMATIC CHANGES INDUCED BY SUPERIOR AND SUPEROTEMPORAL CORNEAL INCISION IN ULTRASOUND PHACOEMULSIFICATION CATARACT SURGERY
Published 2025 - 29th ESCRS Winter Meeting
Reference: PO277 | Type: Presented Poster & Poster | DOI: 10.82333/c8r5-m823
Authors: Suzana Matić* 1 , Lucija Matic 2 , Ivana Strunje 3 , Marija Jelic-Vukovic 3 , Mate Matic 4 , Vedran Nemet 3 , Marija Matic 5
1Department of Ophthalmology,University Hospital Centre,Osijek,Croatia;Faculty of Medicine,Josip Juraj Strossmayer University of Osijek,Osijek ,Croatia, 2Faculty of Dental Medicine And Health,Josip Juraj Strossmayer University of Osijek,Osijek,Croatia, 3Department of Ophthalmology,University Hospital Centre,Osijek,Croatia;Faculty of Medicine,Josip Juraj Strossmayer University of Osijek,Osijek,Croatia, 4Department of Oncology,University Hospital Centre,Osijek,Croatia;Faculty of Medicine,Josip Juraj Strossmayer University of Osijek,Osijek,Croatia, 5Faculty of Medicine,University of Mostar,Mostar,Bosnia and Herzegovina
Purpose
The aim of the study was to compare preoperative and postoperative astigmatism changes after superior versus superotemporal clear corneal incision (CCI) during ultrasound phacoemulsification cataract surgery (PHACO).
Setting
Prospective cohort study
Methods
The study included 60 patients divided into 2 groups, each of 30 patients, who underwent PHACO. The preoperative evaluation comprised the best corrected visual acuity (BCVA) assessment and keratometry (K) on the day of the surgery and one month after the surgery, intraocular lens (IOL) power calculation on IOL Master Zeiss 700 device. All surgeries were perfomed on Centurion device (Alcon, 2020.) by the same surgeon. In the first group of patients the main 2,75 mm clear corneal incision (CCI) was made by the superior approach on 90 degrees and by the temporal approach in the second group. Exclusion criteria were patients with astigmatism higher than 3 diopters, prior corneal surgeries, complicated cataract, any eye disease, eye trauma or sistemic diseases. Adequate score was assigned to each preoperative and postoperative K-value with associated axis of astigmatism to enable comparison using Morlet modified table for manual scoring of astigmatism. Wilcoxon paired samples test was used for statistical analysis.
Results
The mean age of patients was 68 ± 12. Most of patients were males (52%) versus female (42%), with no statistically significant difference between gender (Fisher exact test,p-value =0.71). BCVA was statistically significantly improved after PHACO (Wilcoxonov test, P < 0,001) with preoperative BCVA 0.3±0.2 in superotemporal group and BCVA 0,5±0.2 in superior group and postoperative BCVA 1.0(-0.1) in both groups (Wilcoxon test,p<0.001). Patients with superior CCI had significantly better BCVA compared to patients with superotemporal CCI, both before (Mann Whitney U test, P=0,01) and after the surgery (Mann Whitney U test, P=0,03). Patients with superotemporal CCI had significantly higher astigmatism before (Mann Whitney U test, P= 0,01) and after PHACO (Mann Whitney U test, P=0,004).
Conclusion
Preoperative and postoperative astigmatism was higher in patients who underwent superotemporal CCI than in patients who underwent superior CCI. Patients who underwent superior CCI achieved better BCVA compared to those underwent superotemporal CCI. It is of big importance to plan the axis of incision in aim of minimizing postsurgical astigmatism and achieving optimum BCVA.