Lamellar keratotomy to correct astigmatism in cataract surgery.
BACKGROUND
For the correction of astigmatism in cataract surgery, several incisional procedures have been developed. In this study, a modification of lamellar keratotomy was evaluated to correct astigmatism in cataract surgery.


METHODS
Prospectively 32 eyes of 25 patients with a preoperative astigmatism greater than 1.5 D were studied. All patients were treated with lamellar keratotomy with an incision width of 6 mm and a radial length of 1.5 mm placed at the limbus in the steep meridian. Phacoemulsification and IOL implantation were then performed through a 3.2-mm corneal tunnel incision. After 4 weeks, mean astigmatism, mean corneal power changes, and mean surgically-induced astigmatism derived from vector analysis in the central 3-mm optical zone were determined.


RESULTS
The mean astigmatism decreased from 2.75 +/- 0.80 D preoperatively to 1.58 +/- 0.91 D after 4 weeks (P < 0.001). There were no significant changes (P=0.614) of the mean corneal power. The mean surgically-induced astigmatism was 2.59 +/- 1.50 D. The induced changes were more accentuated in superior incisions. In corneal topography, 78% of the treated eyes revealed a characteristic threefold pattern of the mid-peripheral cornea postoperatively, which impaired the corneal optical performance in ray-tracing analysis.


CONCLUSIONS
Lamellar keratotomy effectively reduced high preoperative astigmatism in cataract surgery. This surgical approach was combined with a superior, temporal, or oblique corneal incision.
Wirbelauer
Christopher
C
Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin, Germany. christopher.wirbelauer@vivantes.de
Böhm
Tiziana
T
Häberle
Heike
H
Pham
Duy Thoai
DT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D002387:Cataract Extraction / Q000009:adverse effects; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014792:Visual Acuity