title: Corneal higher-order aberrations after phacoemulsification: a comparison of 3 different incision sizes.
abstract: OBJECTIVE
  To analyze the impact of different incision sizes for phacoemulsification on corneal higher-order aberrations (HOA).
  
  
  METHODS
  Patients seeking cataract surgery were randomly assigned to one of the following groups: 1.4 mm with biaxial microincision phacoemulsification (25 eyes), 1.8 mm with coaxial phacoemulsification (27 eyes), and 2.2 mm with coaxial phacoemulsification (62 eyes). Inclusion criteria were a minimum age of 18 years and uncomplicated cataract. Exclusion criteria were history of ocular trauma or intraocular surgery, any sign of inflammation or infection, pseudoexfoliation syndrome, glaucoma, optic atrophy, diabetic retinopathy, lens dislocation, cataracta intumescens, cataracta matura, and corneal diseases. Patients underwent phacoemulsification with implantation of an intraocular lens. Aberrometry was performed using an iTrace aberrometer with a pupil scan size of 5.0 mm preoperatively and at postoperative follow-up visits after 1 month. The paired sample t test and analysis of covariance were used for statistical analysis.
  
  
  RESULTS
  Ninety patients (114 eyes) were enrolled (mean age 73.7 ± 8.9 years). In all groups, an increase of total HOAs could be measured. The strongest increase was seen in the 2.2 mm group (mean difference 0.031 [95% confidence interval (CI) 0.006-0.056], p = 0.014) and in the 1.4 mm group (mean difference 0.035 [95% CI -0.007 to 0078], p = 0.097). No important difference was found in the 1.8 mm group.
  
  
  CONCLUSIONS
  The 2.2 mm and the 1.4 mm incisions seem to have a higher impact on corneal HOAs in comparison to the 1.8 mm incision.
authors: Department of Ophthalmology, Charité-Medical University Berlin, Campus Virchow, Berlin - Germany.
authors: Christoph
authors: C
authors: von Sonnleithner
authors: Department of Ophthalmology, Charité-Medical University Berlin, Campus Virchow, Berlin - Germany.
authors: Daniel
authors: D
authors: Pilger
authors: Department of Ophthalmology, Charité-Medical University Berlin, Campus Virchow, Berlin - Germany.
authors: David
authors: D
authors: Homburg
authors: Department of Ophthalmology, Charité-Medical University Berlin, Campus Virchow, Berlin - Germany.
authors: Tobias
authors: T
authors: Brockmann
authors: Department of Ophthalmology, Charité-Medical University Berlin, Campus Virchow, Berlin - Germany.
authors: Necip
authors: N
authors: Torun
authors: Department of Ophthalmology, Charité-Medical University Berlin, Campus Virchow, Berlin - Germany.
authors: Eckart
authors: E
authors: Bertelmann
mesh_terms: D057128:Aberrometry; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001251:Astigmatism / Q000517:prevention & control; D002386:Cataract / Q000150:complications; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D057108:Corneal Wavefront Aberration / Q000517:prevention & control*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D018918:Phacoemulsification / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D014792:Visual Acuity / Q000502:physiology