title: Surgically induced astigmatism with superior and temporal incisions in cases of with-the-rule preoperative astigmatism.
abstract: OBJECTIVE
  To evaluate surgically induced astigmatism (SIA), postoperative astigmatism, and uncorrected visual acuity (UCVA) after cataract surgery with superior corneal, superior scleral, and temporal corneal 4.0 mm sutureless incisions in cases of preoperative with-the-rule (WTR) astigmatism.
  
  
  METHODS
  Hopital des Quinze-Vingts, Paris, France.
  
  
  METHODS
  This prospective evaluation included patients having phacoemulsification with foldable lens implantation through a 4.0 mm incision. Patients with preoperative WTR astigmatism were randomly assigned to 1 of 3 incisions: superior corneal (Group 1), superior scleral (Group 2), or temporal corneal (Group 3). All patients had autokeratometry preoperatively and postoperatively (1 day, 1 week, 1 month, 1 year). Surgically induced astigmatism using the vector method, postoperative astigmatism, and UCVA (patients whose spherical equivalent was with +/- 1 diopter) were evaluated.
  
  
  RESULTS
  Ninety patients were included in the study; there were 30 in each incision group. One year postoperatively, Group 1 had 1.52 diopters (D) of SIA and 1.36 D of postoperative astigmatism; 53.5% of patients had a UCVA of 20/32 or better, Group 2 had 0.69 D of SIA (P < .05) and 0.67 D of postoperative astigmatism (P < .05); 82.7% of patients had a UCVA of 20/32 or better (P < .05). Group 3 had 0.69 D (P > .05), 0.98 D (P < .05), and 79.3% (P > .05), respectively.
  
  
  CONCLUSIONS
  In this study, the superior corneal incision produced significant SIA, leading to high postoperative astigmatism and poor UCVA. The scleral and temporal incisions produced minimal SIA and good UCVA.
authors.affiliation: Hopital des Quinze-Vingts, Paris, France.
authors.forename: S J
authors.initials: SJ
authors.lastname: Roman
authors.forename: F X
authors.initials: FX
authors.lastname: Auclin
authors.forename: D A
authors.initials: DA
authors.lastname: Chong-Sit
authors.forename: M M
authors.initials: MM
authors.lastname: Ullern
mesh_terms: D000368:Aged; D001251:Astigmatism / Q000209:etiology* / Q000473:pathology; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D018918:Phacoemulsification / Q000009:adverse effects* / Q000379:methods; D011446:Prospective Studies; D012590:Sclera / Q000601:surgery*; D014792:Visual Acuity