Abstract
Purpose: A single-step, self-sealing, 3.2 mm clear corneal section is described and the incidence and variation of surgically induced astigmatism following phacoemulsification over a period of 3 months is determined.
Methods: Twenty-two patients who underwent uncomplicated 3.2 mm clear corneal phacoemulsification with foldable Allergan silicone intraocular lens implantation were autorefracted pre-operatively and on day 1, week 1, week 6 and at 3 months. The variation in induced astigmatism was analysed using the subtraction method and vector analysis. The change in direction of the cylindrical axis was examined.
Results: The induced astigmatism represented by the total vector on day 1 was 1.17 D and vector decomposition ratio, ATR:WTR (against-the-rule:with-the-rule), was 21.05:78.95. The total vector increased by 0.5 D in the first week and then stabilised. Vector decomposition showed an against-the-rule astigmatic drift so that by 3 months the ATR:WTR was 40.49:59.91. There was a tendency of the axis of the negative cylinder to swing towards the corneal section meridian on day 1 and to oscillate around that meridian at week 1 and week 6. By 3 months the direction reverted to that pre-operatively, in most cases.
Conclusions: The single-step, self-sealing clear corneal section is mechanically stable and, though there is some variability in the measured astigmatism, there is an acceptable functional result throughout the post-operative period.
Similar content being viewed by others
Article PDF
References
Kinge B, Midelfart A, Jacobsen G . Clinical evaluation of the Allergan Humphrey 500 autorefractor and the Nidek AR-1000 autorefractor. Br J Ophthalmol 1996;80:35–9.
Suzuki R, Kurimoto S . Similarities and differences between Kelman phacoemulsification and extracapsular cataract extraction procedures in the spontaneous regression of corneal astigmatism from against-the-rule astigmatism. Ophthalmic Res 1992;24:134–41.
Steinen RE, Brint SF, White SM, Fine IH . Astigmatism after small-incision cataract surgery: a prospective randomised multicentre comparison of 4- and 6.5-mm incisions. Ophthalmology 1991;98:417–23.
Kohnen T, Dick B, Jacobi KW . Comparison of astigmatism after temporal clear corneal tunnel incisions of different sizes. J Cataract Refract Surg 1995;21:417–24.
Feil SH, Crandell AS, Olson RJ . Astigmatic decay following small incision, self-sealing cataract surgery: one year follow-up. J Cataract Refract Surg 1995;21:433–6.
Hyashi K, Hyashi H, Nakao F, Hyashi F . The correlation between incision size and corneal shape changes in sutureless cataract surgery. Ophthalmology 1995;102:550–6.
Levy JH, Pisacano AM, Chadwick K . Astigmatic changes after cataract surgery with 5.1 mm and 3.5 mm sutureless incisions. J Cataract Refract Surg 1994;20:630–3.
Ernest PH, Fenzl R, Lavery KT, Sensoli A . Relative stability of clear corneal incisions in cadaver eye model. J Cataract Refract Surg 1995:21:39–42.
Ernest PH, Lavery KT, Kiessling LA . Relative strength of scleral corneal and clear corneal incisions constructed in cadaver eyes. J Cataract Refract Surg 1994;20:626–7.
Anders N, Pham DT, Wollensak J . Wound strength in self-sealing cataract surgery depending on the site and depth of incision [in German]. Klin Monatsbl Augen-heilkd 1995;206:442–5.
Kohnen T, Mann PM, Husain SE, Abarca A, Koch DD . Corneal topographic changes and induced astigmatism resulting from superior and temporal scleral pockets. Ophthalmic Surg Lasers 1996;27:263–9.
Kohnen T, Dick B . Computerised videokeratographic analysis of astigmatism induced by temporal corneal tunnel incision for phacoemulsification. Invest Ophthalmol Vis Sci 1994;35:1435.
Hyashi K, Nakao F, Hyashi F . Corneal topographical analysis of superolateral incision of cataract surgery. J Cataract Refract Surg 1994;20:392–9.
Steinert RF, Deacon J . Enlargement of incision width during phacoemulsification and folded intraocular lens surgery. Ophthalmology 1996;103:220–5.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rauz, S., Reynolds, A., Henderson, H. et al. Variation in astigmatism following the single-step, self-sealing clear corneal section for phacoemulsification. Eye 11, 656–660 (1997). https://doi.org/10.1038/eye.1997.172
Issue Date:
DOI: https://doi.org/10.1038/eye.1997.172
Keywords
This article is cited by
-
Comparison of surgically induced astigmatism between anterior and total cornea in 2.2 mm steep meridian incision cataract surgery
BMC Ophthalmology (2021)
-
Changes in corneal aberrations after cataract surgery
Japanese Journal of Ophthalmology (2016)
-
A nationwide survey of post-operative instructions following uncomplicated phacoemulsification cataract surgery
Eye (2001)