title: Optimal incision sites to reduce corneal aberration variations after small incision phacoemulsification cataract surgery.
abstract: OBJECTIVE
  To analyze the effect of steep meridian small incision phacoemulsification cataract surgery on anterior, posterior and total corneal wavefront aberration.
  
  
  METHODS
  Steep meridian small incision phacoemulsification cataract surgery was performed in age-related cataract patients which were divided into three groups according to the incision site: 12 o'clock, 9 o'clock and between 9 and 12 o'clock (BENT) incision groups. The preoperative and 3-month postoperative root mean square (RMS) values of anterior, posterior and total corneal wavefront aberration including coma, spherical aberration, and total higher-order aberrations (HOAs), were measured by Pentacam scheimpflug imaging. The mean preoperative and postoperative corneal wavefront aberrations were documented.
  
  
  RESULTS
  Total corneal aberration and total lower-order aberrations decreased significantly in three groups after operation. RMS value of total HOAs decreased significantly postoperatively in the 12 o'clock incision group (P<0.001). Corneal spherical aberration was statistically significantly lower after steep meridian small incision phacoemulsification cataract surgery in BENT incision group (P<0.05) and Pearson correlation analysis indicated that spherical aberration changes had no significant relationship with total astigmatism changes in all three corneal incision location.
  
  
  CONCLUSIONS
  Corneal incision of phacoemulsification cataract surgery can affect corneal wavefront aberration. The 12 o'clock corneal incision eliminated more HOAs and the spherical aberrations decreased in BENT incision group obviously when we selected steep meridian small incision. Cataract lens replacement using wavefront-corrected intraocular lens combined with optimized corneal incision site would improve ocular aberration results.
authors.affiliation: AIER Eye Hospital of Shenyang, Shenyang 110005, Liaoning Province, China; Eye Hospital of China Medical University; Department of Ophthalmology, the 4th Affiliated Hospital of China Medical University; Provincial Key Laboratory of Lens Research, Shenyang 110005, Liaoning Province, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Chu
authors.affiliation: AIER Eye Hospital of Shenyang, Shenyang 110005, Liaoning Province, China.
authors.forename: Jiang-Yue
authors.initials: JY
authors.lastname: Zhao
authors.affiliation: AIER Eye Hospital of Shenyang, Shenyang 110005, Liaoning Province, China.
authors.forename: Jin-Song
authors.initials: JS
authors.lastname: Zhang
authors.affiliation: AIER Eye Hospital of Shenyang, Shenyang 110005, Liaoning Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Meng
authors.affiliation: Department of Ophthalmology and Vision Science, the University of Arizona College of Medicine, Tucson, AZ 85711-1824, USA.
authors.forename: Ming-Wu
authors.initials: MW
authors.lastname: Wang
authors.affiliation: AIER Eye Hospital of Shenyang, Shenyang 110005, Liaoning Province, China.
authors.forename: Ya-Jing
authors.initials: YJ
authors.lastname: Yang
authors.affiliation: AIER Eye Hospital of Shenyang, Shenyang 110005, Liaoning Province, China.
authors.forename: Jia-Ming
authors.initials: JM
authors.lastname: Yu
keywords: cataract surgery; corneal aberration; corneal incision