A Quasi-Experimental Study on Effects of 3.2mm Supratemporal Clear Corneal Incision during Phacoemulsification on Preoperative Astigmatism: Bridging Theory and Surgical Practice

Junaid Sethi; Fawad Ahmad; Nuzhat  Rahil

doi:10.37762/jgmds.12-3.731

Authors

Junaid Sethi Lady Reading Hospital, Peshawar
Fawad Ahmad Lady Reading Hospital, Peshawar
Nuzhat Rahil Lady Reading Hospital, Peshawar

DOI:

https://doi.org/10.37762/jgmds.12-3.731

Keywords:

PGRS, Clear cornea, Cataract, Phacoemulsification, and With and Against the Rule of Astigmatism

Abstract

OBJECTIVES

This study aimed to evaluate the effect of 3.2 clear corneal superotemporal incisions on postoperative astigmatism in patients surgically treated with phacoemulsification for cataract extraction, thereby bridging the gap between theory and surgical practice.
METHODOLOGY

This quasi-experimental study was conducted in the ophthalmology department of the Medical Teaching Institute, Lady Reading Hospital, Peshawar, from February 2024 to August 2024, following ethical approval and informed consent from the patients. Seventy-three patients presenting with non-complicated and non-traumatic cataracts between the ages of 20 and 85 years were enrolled. Phacoemulsification surgery was performed on these patients of both genders. A 3.2 super temporal clear corneal incision is used during phacoemulsification surgery. Using the Keratometer and comparing the corneal dioptric power along the horizontal and vertical meridians, the pre-and post-operative astigmatism at 3- and 6-month follow-ups was assessed. The data was entered and analyzed using SPSS version 25.

RESULTS
A total of 73 patients with cataracts were enrolled in this study. The patients' mean age was 61.6 ± 11.9 years. The ratio of male to female was in the ratio of 2:1. The mean pre-operative astigmatism was 0.88±0.4947D. The mean astigmatism after surgery was 1.15±0.748 D, and after 6 months, it decreased to 0.67 D. Following the study, the young surgeons in years 3 and 4 learned about the negating effect of this incision.

CONCLUSION

There was no significant difference in astigmatism when followed postoperatively over an extended period of 6 months with a 3.2 mm supratemporal clear corneal incision during phacoemulsification. The practical aspect of the study yielded more satisfactory results during the training of Postgraduate residents (PGRs).

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Author Biographies

Junaid Sethi, Lady Reading Hospital, Peshawar

Assistant Professor, Department of Ophthalmology,
Lady Reading Hospital, Peshawar

Fawad Ahmad, Lady Reading Hospital, Peshawar

Ex-Post Graduate Resident, Department of Ophthalmology
Lady Reading Hospital, Peshawar

Nuzhat Rahil, Lady Reading Hospital, Peshawar

Assistant Professor, Head of Department of Ophthalmology,
Lady Reading Hospital, Peshawar

References

Cicinelli MV, Buchan JC, Nicholson M, Varadaraj V, Khanna RC. Cataracts. The Lancet. 2023;401(10374):377–89 DOI: https://doi.org/10.1016/S0140-6736(22)01839-6

Davis G. The evolution of cataract surgery. Mo Med. 2016;113(1):58 DOI: https://doi.org/10.1111/dmcn.55_13225

Ambadkar S, Thool A. Comparative Study of Postoperative Astigmatism Following Phacoemulsification with Scleral Incision and Posterior Chamber Foldable and Rigid (Nonfoldable) Intraocular Lens Implantation. Journal of Datta Meghe Institute of Medical Sciences University. 2021;16(4):616–9 DOI: https://doi.org/10.4103/jdmimsu.jdmimsu_193_20

Borkenstein AF, Packard R, Dhubhghaill SN, Lockington D, Donnenfeld ED, Borkenstein EM. Clear corneal incision, an important step in modern cataract surgery: a review. Eye. 2023;37(14):2864–76 DOI: https://doi.org/10.1038/s41433-023-02440-z

Gautam N, Kumar S, Shahnawaz A. Postoperative Corneal Astigmatism Following Cataract Phacoemulsification Using 3.2 Mm Clear Corneal Supertemporal Incision: Report From a Tertiary Care Hospital In Bihar. Int J Acad Med Pharm. 2023;5(3):637–40

Shi DS, Jensen JD, Kramer GD, Zaugg B, Stagg BC, Pettey JH, et al. Comparison of vacuum and aspiration on phacoemulsification efficiency and chatter using a monitored forced infusion system. Am J Ophthalmol. 2016; 169:162–7 DOI: https://doi.org/10.1016/j.ajo.2016.06.030

Laliwala F, Patel S, Prajapati V, Patel L, Wanjari MB, Singhal D, et al. Comparative evaluation of astigmatic changes induced by superior and temporal corneal incisions in sutureless phacoemulsification surgery: a case series. Cureus. 2023;15(10) DOI: https://doi.org/10.7759/cureus.48084

Madhani CH, Trivedi KY, Bhagat PR. Global preferred practice patterns in manual small incision cataract surgery. Glob J Cataract Surg Res Ophthalmol. 2022;1:4–9 DOI: https://doi.org/10.25259/GJCSRO_6_2021

Kholmatova Y. Definition and General Description of Cataract. Spanish Journal of Innovation and Integrity. 2024; 37:91–4

Zhang J, Wu Y, Sharma B, Gupta R, Jawla S, Bullimore MA. Epidemiology and burden of astigmatism: a systematic literature review. Optometry and Vision Science. 2023;100(3):218–31 DOI: https://doi.org/10.1097/OPX.0000000000001998

Wang KM, Jun AS, Ladas JG, Devgan U. Phacoemulsification: principles and techniques. In: Albert and Jakobiec’s Principles and Practice of Ophthalmology. Springer; 2022. p. 1467–89 DOI: https://doi.org/10.1007/978-3-030-42634-7_191

Day AC, Dhariwal M, Keith MS, Ender F, Vives CP, Miglio C, et al. Distribution of preoperative and postoperative astigmatism in a large population of patients undergoing cataract surgery in the UK. British Journal of Ophthalmology. 2019;103(7):993–1000.

Najafi A, Ojaghi H, Zahirian Moghadam T, Sharghi A. Prevalence of types of corneal astigmatism before cataract surgery International journal of Pharmaceutical Research. 2020;12(2):303–11 DOI: https://doi.org/10.31838/ijpr/2020.12.02.0044

Day AC, Dhariwal M, Keith MS, Ender F, Vives CP, Miglio C, et al. Distribution of preoperative and postoperative astigmatism in a large population of patients undergoing cataract surgery in the UK. British Journal of Ophthalmology. 2019;103(7):993–1000 DOI: https://doi.org/10.1136/bjophthalmol-2018-312025

F Ali -. Surgically Induced Astigmatism after Phacoemulsification with Clear Corneal 3.2 Mm Incision While Using Superior versus Temporal Approach

Kusagur SR, Manjunath BH, Nayak P V. Comparative study of postoperative astigmatism in temporal scleral incision phacoemulsification versus temporal clear corneal incision phacoemulsification. Kerala Journal of Ophthalmology. 2024;36(3):253–7. DOI: https://doi.org/10.4103/kjo.kjo_43_23

Junjie Piao. Site of clear corneal incision in cataract surgery and its effects on surgically induced astigmatism. 2020; DOI: https://doi.org/10.1038/s41598-020-60985-5

Ahmed S, Sayed M, Mahran W. Refractive changes with corneal incision 2.8mm after phacoemulsification. Egyptian Journal of Medical Research. 2022 Oct 1;3(4):72–85 DOI: https://doi.org/10.21608/ejmr.2022.267212

Rauf A, Farooq A, Malik MB, Khan AM, Abbas H, Suri AK. Comparison of Surgically Induced Astigmatism between Superior and Supero-Temporal Incisions in Manual Small Incision Cataract Surgery. Pakistan Armed Forces Medical Journal. 2022;72(6):2002 DOI: https://doi.org/10.51253/pafmj.v72i6.3613

Global estimates on the number of people blind or visually impaired by cataract: a meta-analysis from 2000 to 2020. Eye. 2024;38(11):2156–72

González-Cruces T, Cano-Ortiz A, Sánchez-González MC, Sánchez-González JM. Cataract surgery, astigmatism, incisional management. Manual relaxing incision versus femtosecond laser-assisted arcuate keratotomy. A systematic review. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2022;260(11):3437–52 DOI: https://doi.org/10.1007/s00417-022-05728-0