Corneal topographic changes induced by different oblique cataract incisions.
OBJECTIVE
To compare astigmatic and topographic changes induced by different oblique cataract incisions.


METHODS
Department of Ophthalmology, Hospital of San Donà di Piave, Venice, Italy.


METHODS
One hundred sixty-eight eyes having phacoemulsification were randomly assigned to 1 of 3 groups: 3.5 mm clear corneal incision (CCI), 60 eyes; 5.5 mm sutured CCI, 54 eyes; 5.5 mm scleral tunnel, 54 eyes. Incisions lay on the 120 degree semimeridian. Corneal topography was performed preoperatively and 1 week and 1 and 3 months postoperatively. Simulated keratometric readings were used to calculate astigmatism amplitude and surgically induced astigmatism (SIA). Postoperative topographic changes were determined by subtracting the preoperative from the postoperative numeric map readings.


RESULTS
Three months postoperatively, the mean SIA in the right and left eyes, respectively, was 0.68 diopter (D) +/- 1.14 (SD) and 0.66 +/- 0.52 D in the 3.5 mm CCI group, 1.74 D +/- 1.43 D and 1.64 +/- 1.27 D in the 5.5 mm CCI group, and 0.46 +/- 0.56 D and 0.10 +/- 1.08 D in the scleral tunnel group. Right and left eyes showed similar SIA amplitude but different SIA axis orientation. The SIA was significantly higher in the 5.5 mm CCI group than in the other 2 groups 1 and 3 months postoperatively (P <.01). All groups showed significant wound-related flattening and nonorthogonal steepening at 2 opposite radial sectors. Topographic changes were significantly higher in the 5.5 mm CCI group and significantly lower in the scleral tunnel group.


CONCLUSIONS
Right and left eyes showed similar SIA amplitude but different SIA axis orientation and topographic modifications, probably because of the different superotemporal and superonasal corneal anatomic structure. The 5.5 mm CCI induced significantly higher postoperative astigmatism, SIA, and topographic changes.
Beltrame
G
G
Department of Ophthalmology, Hospital of San Donà di Piave, Venice, Italy.
Salvetat
M L
ML
Chizzolini
M
M
Driussi
G
G
D000368:Aged; D001251:Astigmatism / Q000175:diagnosis / Q000209:etiology*; D003315:Cornea / Q000473:pathology / Q000601:surgery; D019781:Corneal Topography; D005260:Female; D006801:Humans; D008297:Male; D018918:Phacoemulsification / Q000009:adverse effects* / Q000379:methods; D019904:Polymethyl Methacrylate; D011446:Prospective Studies; D012590:Sclera / Q000601:surgery; D012826:Silicone Elastomers; D013524:Surgical Flaps; D013536:Suture Techniques / Q000009:adverse effects*
D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate