title: Astigmatic change in biaxial microincisional  cataract surgery with enlargement of one incision:  a prospective controlled study.
abstract: OBJECTIVE
  To investigate the astigmatic changes induced by biaxial microincisional cataract surgery with enlargement of one incision to accommodate a foldable standard lens.
  
  
  METHODS
  In a prospective controlled trial one eye each of 50 patients was evaluated. Two temporal microincisions were applied and the right-hand incision was enlarged to 2.8 mm to allow for the insertion of the lens. Based on preoperative and postoperative keratometry readings, vector analysis was performed to calculate the surgically induced astigmatism (SIA) and the flattening effect of each of the two incisions at their meridia. To assess the degree of measurement error, a non-surgical control group underwent keratometry over the same time frame and vector analysis was used to calculate the same indices based on the variation in the keratometry readings.
  
  
  RESULTS
  Six weeks postoperatively, mean SIA was 0.66 +/- 0.08 D in the study group and 0.51 +/- 0.05 D in the non-surgical control group (P = 0.041). At the right-hand incision, a flattening of 0.34 +/- 0.09 D was measured in the study group as opposed to a steepening of 0.03 +/- 0.06 D in the control group (P < 0.001). At the smaller left-hand incision, steepening effects of 0.28 +/- 0.08 and 0.05 +/- 0.06 D occurred, respectively (P = 0.011).
  
  
  CONCLUSIONS
  Biaxial microincisional cataract surgery with enlargement of one incision to 2.8 mm is not astigmatically neutral, demonstrating a statistically significantly larger SIA than that attributable to measurement error.
authors.affiliation: Department of Ophthalmology, University of Zurich, Zurich, Switzerland.
authors.forename: Claude
authors.initials: C
authors.lastname: Kaufmann
authors.forename: Michael A
authors.initials: MA
authors.lastname: Thiel
authors.forename: Adrian
authors.initials: A
authors.lastname: Esterman
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Dougherty
authors.forename: Michael
authors.initials: M
authors.lastname: Goggin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000209:etiology*; D002386:Cataract / Q000628:therapy*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods; D008297:Male; D018918:Phacoemulsification / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity