Comparative study of surgically induced astigmatism in superior versus temporal incision in small incision cataract surgery cases

Authors

  • Kuruva Nandyala Sree Kavitha Department of Ophthalmology, Sarojini Devi Eye Hospital and Regional Institute of Ophthalmology, Hyderabad
  • Arikeri Krishna Kishore Department of Ophthalmology, Sarojini Devi Eye Hospital and Regional Institute of Ophthalmology, Hyderabad
  • Ganta Sudhakar Reddy Department of Ophthalmology, Sarojini Devi Eye Hospital and Regional Institute of Ophthalmology, Hyderabad
  • Khaiser Jehan Sarojini Devi Eye Hospital and Regional Institute of Ophthalmology, Hyderabad

DOI:

https://doi.org/10.18203/2320-6012.ijrms20150938

Keywords:

With the rule astigmatism, Against the rule astigmatism, Superior incision, Temporal incision

Abstract

Background: Location of incision has a significant impact on surgical outcome. It has been reported that temporal incisions induce less astigmatism than superior incisions indicating the importance of incision location. The objective of the present study was to study the effect of surgical induced astigmatism in superior versus temporal incision in small incision cataract surgery cases.

Methods: 100 patients of cataract attending to Sarojini Devi eye hospital with the rule and against the rule astigmatism were included in the study. The astigmatic profile and the effect of surgical incision on astigmatism were studied. A prospective study was done in which patients were divided into two groups. MSICS was performed with superiorly located incision in group I and temporally located incision in group II.

Results: Out of the total 100 patients undergoing MSICS, 59 patients had ATR, 36 patients had WTR and 5 patients had no astigmatism. Thus the pre-operative astigmatic profile shows that ATR is more common type of astigmatism in this group. Among 50 patients in superior incision group, 18 had pre-operative WTR, 29 had ATR and 3 did not have astigmatism. Postoperatively the no. of patients with WTR decreased to 10, the no. of patients with ATR increased to 35 showing that superior incision flattens vertical meridian and steepens the horizontal meridian causing ATR shift. Among 50 patients in temporal incision group, 18 had pre-operative WTR, 30 had ATR and 2 did not have astigmatism. Post operatively the no of patients with WTR increased to 25, the no of patients with ATR decreased to 20.

Conclusions: Placement of incision on steep axis reduces pre-existing astigmatism. Thus in ATR astigmatism it is placed temporally and in WTR astigmatism it is placed superiorly. Thus a simple modification in incision placement can minimize surgically induced astigmatism and reduce pre-existing astigmatism

 

References

Gokhale NS, Sawhney S. Reduction in astigmatism in manual small incision cataract surgery through change of incision site. Indian J Ophthalmol. 2005;53:201-3.

Magdum RM, Gahlot A, Maheshgauri RD, Khevna P. A comparative study of surgically induced astigmatism in superior and temporal scleral incision in manual small incision cataract surgery. National Journal of Medical Research. 2012;2(4):497.

Alam J, Bhattacharjya H, Roy A, Das R, Gupta S, Bhattacharya U, et al. A Comparative Study of Post-Operative Astigmatism in Superior versus Temporal Approach of Manual Small Incision Cataract Surgery”. Journal of Evolution of Medical and Dental Sciences. 2014;3(26):7087-90.

Mallik VK, Kumar S, Kamboj R, Jain C, Jain K, Kumar S. Comparison of astigmatism following manual small incision cataract surgery: superior versus temporal approach. Nepal J Ophthalmol. 2012;4(2):343.

Radwan AA. Comparing Surgical-Induced Astigmatism through Change of Incision Site in Manual Small Incision Cataract Surgery (SICS). J Clinic Experiment Ophthalmol. 2011;2:161.

Pawar VS, Sindal DK. A comparative study on the superior, supero-temporal and the temporal incisions in small incision cataract surgeries for post-operative astigmatism. Journal of Clinical and Diagnostic Research. 2012;6:1229-32.

Oshika T, Samejima T, Miyata N. Calculation of surgically induced astigmatism. Nihon Ganka Gakkai Zasshi. 1995;99(8):901-9.

Yadav H, Rai V. A Study of Comparison Astigmatism Following Manual Small Incision Cataract Surgery: Superior versus Temporal Approach. Journal of Evolution of Medical and Dental Sciences. 2014;3(23):6430-4.

Koch PS: Structural analysis of cataract incision construction. J Cataract Refractive Surgery. 1991;117(Suppl):677-88.

Ernest PH, Lavery KT, Kiessling LA. Relative strength of scleral tunnel incisions with internal corneal lips constructed in cadaver eyes. J Cataract Refract Surg. 1993;19:457-61.

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Published

2017-01-16

How to Cite

Kavitha, K. N. S., Kishore, A. K., Reddy, G. S., & Jehan, K. (2017). Comparative study of surgically induced astigmatism in superior versus temporal incision in small incision cataract surgery cases. International Journal of Research in Medical Sciences, 3(11), 3027–3031. https://doi.org/10.18203/2320-6012.ijrms20150938

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Section

Original Research Articles