Analyzing Outcome of Corneal Arcuate Incisions in Laser Refractive Cataract Surgery in Patients With Mild–Moderate Corneal Astigmatism

Sunday, April 19, 2015: 8:16 AM
Room 4 (San Diego Convention Center)
Chitra R. Ramamurthy, MD
Ramamurthy Dandapani, MD
Shreyas Ramamurthy, MD
Jaykumar B. Shah, MD

To analyze the predictability and efficacy of corneal arcuate incisions in management of patients with mild-moderate corneal astigmatism in laser refractive cataract surgery.

Seventy-three patients who underwent LRCS with corneal astigmatism ≥ 0.75D were included in the study. Design was retrospective, consecutive case series. Pts with retinal pathology like diabetic retinopathy, ARMD which can hinder postoperative BCVA were excluded from the study. Uncorrected visual acuity, BCVA, manual keratometry and corneal topography were done preoperatively and postoperatively. Intraoperatively, corneal arcuate incisions were made depending on the preoperative corneal keratometry. Patients were divided in 3 groups based on astigmatism. Group A with astigmatism of < 1D, Group B with astigmatism of 1D–2D and Group C with astigmatism of > 2D. Follow-up period was 6 months.

Group A (<1D) had a 26 pts (35.7%) preop which increased to 63 pts (86.3%) postop. Group B (1-2D) had 41 pts (56.2%) preop which dramatically reduced to 8 pts (10.9%) postop. Group C (>2D) had 6 pts (8.2%) preop which reduced to 2 pts (2.7%) postop. The above results indicate a shift of patients from a higher astigmatism group to a lower astigmatism group, which indirectly indicates good predictability of corneal arcuate incisions.  Furthermore 27 patients had nil astigmatism postop, of which 26 patients had UCVA of 6/6. All patients had BCVA of 6/6 postoperatively suggesting enhanced safety of LRCS.

Corneal arcuate incisions have good predictability and efficacy in patients with mild-moderate astigmatism in LRCS and conclude a definitive role in astigmatism management.