A Randomized Clinical Trial To Evaluate Surgically Induced Astigmatism After Phacoemulsification With Temporal Scleral Incision And Superior Scleral Incision

Abstract

Background Cataract is opacity in the lens capsule or its substance. The mainstay of management of cataract is surgery and with the advent of foldable intraocular lens and Remarkable development in phacoemulcification it is possible to implant lens through an incision small as 2.2mm, which helps in significantly reducing post operative astigmatism. Aims and Objectives of this study were To evaluate the outcome of surgically induced astigmatism by comparing the superior sclera incision and temporal sclera incision in phacoemulcification with foldable lens. To compare the pre operative and post operative astigmatism in superior and temporal scleral incisions. Methods: The prospective study was conducted at B.L.D.E.U‘S Shri B.M .Patil medical college, Hospital and Research Centre, Vijayapur from December 2014- May 2016. A total of 116 patients were included in the study clinically diagnosed of immature senile cataract. All patients were evaluated in detail regarding grading of cataract, visual acuity, keratometry, slit lamp examination, fundus and detailed evaluation was done. Patients were divided into ―WITH THR RULE‖ and ―AGAINST THE RULE‖ groups based on keratometry readings. Results: The present student was done among 116 patients and evaluated surgically induced astigmatism. x Patients divided into two Groups (Group 1- Superior scleral incision) and (Group 2- Temporal scleral incision) . 53.4% patients in Group 1 had with the rule and 25.9% patients had against the rule astigmatism. In Group 2 34.4% patients had with the rule and 48.3% patients had ATR astigmatism. 34.4% patients in group 1, developed WTR astigmatism after phacoemulsification. 60.3% patients developed ATR astigmatism. 56.9% patients of group 2 developed WTR astigmatism while 37% patients developed ATR astigmatism. in Group 1, 27.6% patients developed WTR astigmatism, with a mean astigmatism of 0.72D and 62.1% patients developed ATR astigmatism with a mean astigmatism of 1.00D. in Group 2, 53.4% patients developed WTR astigmatism with a mean astigmatism of 0.79D and 31.1% patients developed ATR astigmatism having a mean of 0.46D. the average surgical induced astigmatism in patients who underwent phacoemulsification with superior scleral incision and temporal scleral incision was 0.83D and 0.54D respectively. Interpretation & Conclusion: The current study shows that temporal scleral incisions seem to achieve the goal of minimizing surgically induced astigmatism. Temporal scleral incision is evidently better than superior scleral incision in minimizing surgically induced astigmatism.