Surgically Induced Astigmatism After Coaxial and Biaxial Cataract Surgery With Different Wound Sizes
To compare surgically induced astigmatism (SIA) following co-axial cataract surgery through a 1.8 mm, 2.2 mm and 3.0 mm versus bi axial cataract surgery through a 1.3 mm corneal wound.
Prospective comparative interventional case series. 194 eyes undergoing cataract surgery by a single surgeon were randomly allocated into four groups based on the size of the clear corneal wound size. Group one (n= 50), group two (n=50) and group three (n=44) underwent co- axial cataract surgery through a 1.8 mm, 2.2 mm and 3.0 mm respectively. Group four (n=50) underwent bi axial cataract surgery through a 1.3 mm incision. All subjects underwent preoperative biometry with optical biometry. Post operative keratometry was performed at four weeks time gate in all subjects. SIA was calculated using commercially available software. EyePro (version 1.5).
There were no intraoperative or postoperative complications. Mean SIA was 0.23 D ± 0.68 D, 0.22 D ± 0.76 D and 0.37 D ± 1.02 D in the 1.8 mm, 2.2 mm, and 3.0 mm group respectively. Mean SIA for the 1.3 mm bi axial group was 0.18 D ± 0.54 D.
Bi-axial cataract surgery with a 1.3 mm corneal wound causes less SIA compared to co-axial cataract surgery. Among the co-axial group, 1.8 mm clear corneal wound induces less SIA compared to a 3.0 mm clear corneal wound. This information could help surgeons to customize their IOL selection during cataract surgery.