Minimal astigmatism after sutureless planned extracapsular cataract extraction

Department of Ophthalmology, Tel Aviv University, Tell Afif, Tel Aviv, Israel
Journal of Cataract and Refractive Surgery (Impact Factor: 2.72). 04/2002; 28(3):499-503. DOI: 10.1016/S0886-3350(01)01263-9
Source: PubMed


To evaluate astigmatism after mini-nuc extracapsular cataract extraction (ECCE) in which a chevron incision is enlarged to 6.0 to 7.0 mm for easier nucleus removal and to compare the results with those using a 5.0 mm incision.
Department of Ophthalmology, The Edith Wolfson Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Holon, Israel.
Thirty eyes of 29 patients were enrolled in this study. Keratometry was performed preoperatively and 3 to 9 months postoperatively. The incision length was 6.0 mm in 6 eyes, 6.5 mm in 10 eyes, and 7.0 mm in 14 eyes that had mature cataract.
The mean induced astigmatism calculated by simple subtraction was 0.12 diopter (D) +/- 0.51 (SD), 0.16 +/- 0.98 D, and 0.67 +/- 0.91 D for the 6.0 mm, 6.5 mm, and 7.0 mm incision, respectively. By vector analysis, the mean induced astigmatism was 0.60 +/- 0.30 D, 0.75 +/- 0.67 D, and 1.36 +/- 0.77 D, respectively. Results by both methods showed no significant difference between the previously reported 5.0 mm incision and the 6.0 mm and 6.5 mm incisions. The 7.0 mm group had statistically significantly greater induced astigmatism than the 5.0 mm group (P =.01, simple subtraction; P =.002, vector analysis).
Enlarging the size of the chevron incision up to 7.0 mm resulted in a small increase in induced astigmatism. The enlarged incision simplified the operative technique.

10 Reads
  • Source
    • "Manual SICS is an alternative for phacoemulsification but the astigmatism is higher due to the larger size of incision. Burgansky et al have shown an increase in astigmatism with an increase in incision size (Burgansky et al, 2002). In their study by vector analysis, the mean induced astigmatism was 0.6 + 0.3 D for 6 mm incision, 0.75 + 0.67 D for a 6.5 mm incision and 1.36 + 0.77 D for a 7 mm incision. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Now-a-days, all techniques of cataract extraction are meant for giving the best uncorrected visual acuity and early post-operative rehabilitation. Purpose: To compare astigmatism induced by the superior and temporal section in manual small incision cataract surgery (SICS) in the Indian population. Materials and methods: One hundred and ten eyes were taken. Eyes having a steeper vertical keratometry reading were assigned to the superior SICS group whereas eyes with a steeper horizontal keratometry reading were assigned to the temporal SICS group. Eyes with no astigmatism were randomly assigned to either of the two groups. Both the groups had 54 eyes each. Eyes in Group 1 underwent manual SICS with a superior tunnel and eyes in Group 2 underwent manual SICS with a temporal tunnel. The patients were examined on postopera- tive Day1, 1 week, 45 days, and 3 months. Uncorrected and best-corrected visual acuity was recorded, slit-lamp examination, auto-refracto-meter and keratometry examinations were done. Statistics: All calculations were performed using surgically-induced astigmatism (SIA) Calculator version 1.0, a free software program. Results: In Group 2, only 35 eyes out of 54 completed the follow-up of 90 days. The mean SIA in Group1 was found to be 1.45 +/- 0.7387 and in Group 2 it was 0.75+/- 0.4067. The z score applied was found to be 5.7143. This value was more than the standard value, i.e.2.58. The p value accordingly was less than 0.001, which is highly significant. The SIA induced by the superior incision was 48.28 % more than by the temporal incision. Conclusion: SICS with the temporal approach provides a better stabilization of the refraction with a significantly less SIA than superior approach.
    Preview · Article · Feb 2012 · Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To determine whether deep-topical anesthesia is suitable for small-incision manual extracapsular cataract extraction (ECCE). Three hundred twenty-six eyes of 253 patients had small-incision manual ECCE under topical anesthesia with a 4% lidocaine-soaked sponge. The severity of the pain, eye movements, blepharospasm, and intraoperative complications were recorded. Patient and surgeon satisfaction levels were assessed. Operations on 323 eyes (99%) were completed with topical anesthesia. Intraoperatively, topical anesthesia was converted to peribulbar anesthesia in 3 eyes (0.9%) because of excessive eye movements. The cauterization of the scleral vessels and conjunctiva and the subconjunctival injection were the stages causing severe pain. The most frequent intraoperative complication was posterior capsule rupture in 6 eyes (1.8%). The satisfaction level was 95% for the patients and 90% for the surgeon. Deep-topical, nerve-block anesthesia provides anesthesia with sufficient quality for small-incision manual ECCE.
    Full-text · Article · Nov 2004 · Ophthalmic Surgery Lasers and Imaging
  • [Show abstract] [Hide abstract]
    ABSTRACT: To compare the astigmatism induced by a superior, supero-temporal and temporal incision in manual small incision cataract surgery. Induced astigmatism was analysed by Cartesian coordinates based analysis, using Holladay's system. Mean astigmatism induced by surgery was 1.28 Dx2.9 degrees for superior incision, 0.20 Dx23.7 degrees for supero-temporal incision and 0.37 Dx90 degrees for temporal incision. The study found that induced astigmatism was lower in the temporal and superotemporal groups compared to that in the superior group.
    No preview · Article · Oct 2005 · Indian Journal of Ophthalmology
Show more