Comparative study of intraocular lens implantation through 3.0 mm temporal clear corneal and superior scleral tunnel self-sealing incisions.
OBJECTIVE
To compare the clinical outcome of phacoemulsification and foldable silicone intraocular lens (IOL) implantation through a 3.0 mm temporal clear corneal incision and 3.0 mm superior scleral tunnel incision.


METHODS
Department of Ophthalmology, Yodogawa Christian Hospital, Osaka, Japan.


METHODS
Eighty cataractous eyes of 78 patients with pre-existing against-the-rule (ATR) astigmatism were recruited for this prospective, randomized study. The patients were assigned to one of the two groups. Data on uncorrected and corrected visual acuities, keratometry, flare intensity measurement, and central cornea endothelial cell count were evaluated preoperatively and at 2 days, 1 week, and 1 and 3 months postoperatively.


RESULTS
Although the pre-existing keratometric cylinder decreased in the temporal clear corneal incision group and increased in the superior scleral tunnel incision group, the amount of cylinder shift was not significantly different. Mean scalar shift of keratometric cylinder in the corneal incision group was 1.19 diopters (D) at 2 days postoperatively, 0.86 D at 1 week, and 0.56 D at 3 months and in the scleral incision group, 1.09 D at 2 days, 0.76 D at 1 week, and 0.65 D at 3 months. Eighty percent of the eyes in each group achieved an uncorrected visual acuity of 20/40 or better from the second day postoperatively. No statistically significant difference in visual rehabilitation or other parameters was noted between the groups throughout the study. Complications including corneal endothelial cell loss and wound incompetence requiring suturing were observed in the temporal clear corneal incision group.


CONCLUSIONS
Both incisions offered satisfactory clinical results, but the superior scleral tunnel incision resulted in fewer complications. Minimal corneal keratometric change induced by a 3.0 mm incision was not related to uncorrected visual rehabilitation.
Oshima
Y
Y
Department of Ophthalmology, Osaka Rosai Hospital, Japan.
Tsujikawa
K
K
Oh
A
A
Harino
S
S
D000368:Aged; D001251:Astigmatism / Q000150:complications; D002386:Cataract / Q000150:complications; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D012029:Refraction, Ocular; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D014792:Visual Acuity; D014945:Wound Healing