THE MAGNITUDE AND TYPE OF POSTOPERATIVE ASTIGMATISM AFTER SMALL INCISION CATARACT SURGERY AT A TERTIARY CARE CENTRE: A PROSPECTIVE OBSERVATIONAL STUDY.

Abstract

Background:

Cataract is the leading cause of blindness accounting for 51% of blindness worldwide. Manual small incision cataract surgery (MSICS) is the most popular surgical management option for cataracts in developing countries. The location, size, and shape of incisions used in MSICS influence postoperative surgically induced astigmatism (SIA). 

Objective: The aim was to study the magnitude and type of postoperative astigmatism after cataract surgery (MSICS with posterior chamber intraocular lens i.e., PCIOL) by using different sites and shapes for incisions.

Methods:

This prospective observational study included 104 patients presenting to the Department of Ophthalmology M.K.C.G Medical College, Berhampur who had undergone cataract surgery (MSICS) over one year from September 2020 to August 2021.

Results:

Mean surgically induced astigmatism was 1D±0.4840 at the postoperative 3rd month. Superior incisions induced more postoperative astigmatism as compared to Supertemporal and temporal incisions. Straight incision induced more postoperative astigmatism as compared to frown and inverted V or Chevron incision. 

Conclusions:

The site, size, and shape of incisions used in MSICS influence postoperative astigmatism. Incision at the steeper meridian is a simple, safe, and effective procedure to correct mild to moderate preoperative astigmatism at the time of cataract surgery.

Recommendation:

Some surgeons recommend the use of a temporal incision to minimize SIA, as the temporal limbus is further forming the visual axis than the superior limbus.