Clinical evaluation of the arched blade for cataract surgery.
OBJECTIVE
To evaluate the efficacy of the arched blade for making clear corneal incisions in cataract surgery.


METHODS
This prospective study comprised 112 eyes of 74 patients scheduled for cataract surgery. Temporal clear corneal incisions were made with either a 3.2-mm conventional flat blade or the arched blade. The choice of knife was randomly assigned. Two surgeons, one with substantial cataract surgery experience and the other with less experience, performed the surgery. Corneal topography and aberration were examined pre- and postoperatively. The degree of surgically induced astigmatism (SIA) and high order aberration was analysed. The self-sealing ability of the wound was also compared between both blades.


RESULTS
For the less experienced surgeon, the degree of SIA was significantly higher with the 3.2-mm flat blade than with the 3.2-mm arched blade as measured at any time during postoperative follow-up. For the more experienced surgeon, the degree of high order aberration increased significantly with the 3.2-mm flat blade. The incision's self-sealing ability was significantly better when the wound was made with the arched blade rather than with the flat blade.


CONCLUSIONS
The arched blade proved to be effective in reducing surgically induced astigmatism and high order aberration in cataract surgery, particularly when used by the less experienced surgeon. Using the arched blade should lead to better wound self-sealing and, therefore, safer surgical results.
Kojima
Takashi
T
Department of Ophthalmology, Social Insurance Chukyo Hospital, Aichi, Japan. kojikoji@ymail.plala.or.jp
Kaga
Tatsushi
T
Watanabe
Mitsunori
M
Uda
Keiko
K
Naito
Naohisa
N
Saito
Yutaka
Y
Ichikawa
Kazuo
K
D000368:Aged; D001251:Astigmatism / Q000209:etiology / Q000517:prevention & control; D002386:Cataract / Q000150:complications*; D019781:Corneal Topography; D004867:Equipment Design; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000295:instrumentation* / Q000379:methods*; D011446:Prospective Studies; D014945:Wound Healing