Abstract :
Aim: To evaluate the effect of 6mm sutureless clear corneal incision on pre-existing astigmatism of 1D-2D and to compare outcome of superior and temporal incisions, in manual small incision cataract surgery (SICS).
Methods: A prospective interventional study was conducted from January 2015 to July 2015 on 80 patients who underwent manual SICS, with pre-existing astigmatism of 1D-2D on keratometry. A 6mm superior or temporal sutureless clear corneal incision was made along the steep axis. Postoperative follow up was done on 1st, 3rd and 6th week and keratometry values noted in each visit. Final refraction and correction noted at the end of 6 weeks.
Results: Out of 80 patients, 71 had 1D-1.5 D and 9 had 1.5D-2D astigmatism. The mean pre-operative astigmatism was 1.228D±0.32D.
Among 62 cases of with-the rule astigmatism, full correction after surgery was noted in 37 patients (59.67%), partial correction in 19 (30.64%), no change in 6(10%). Among 18 cases of against-the rule astigmatism, 11 had full correction (61.11%) and 6 had partial correction (33.33%) and remained unchanged in 1(5.5%). So the mean post-operative astigmatism was found to be 0.43D±0.35. The astigmatic difference between pre-operative and post-operative astigmatism was found to be statistically significant. (P-value 0.0001).
Peaking of pupil was noted in 3 patients and iris prolapse in two patients, accounting for minor complications in 6.7%. No other complications were observed till 6 weeks.
Conclusion: A 6mm sutureless clear corneal incision on steep axis is an economical and effective way of reducing pre-existing astigmatism of 1D-2D in manual SICS.
Keyword :
Astigmatic correction, Clear corneal incision, Manual small incision cataract surgery, Post-operative astigmatism