Astigmatism outcomes of horizontal temporal versus nasal clear corneal incision cataract surgery

Irina S. Barequet, Edward Yu, Susan Vitale, Sandra Cassard, Dimitri T. Azar, Walter J. Stark

Research output: Contribution to journalArticle

Abstract

Purpose: To compare the short- and long-term astigmatism outcomes after cataract surgery using temporal clear horizontal corneal incisions and nasal horizontal clear corneal incisions. Setting: Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA. Methods: This retrospective study included a consecutive series of eyes having phacoemulsification with implantation of a 6.0 mm foldable acrylic intraocular lens through a 3.5 mm horizontal clear corneal incision at 180 degrees (temporal incision in right eyes, nasal incision in left eyes). Astigmatism was measured by keratometry readings before surgery and 6 weeks and 12 months postoperatively. Results: The mean preoperative astigmatism in the 178 eyes (94 right, 84 left) of 161 patients was 0.78 diopter (D); 54.5% of eyes had against-the-rule (ATR) astigmatism, 22.5% had with-the-rule (WTR) astigmatism, and 14.0% were astigmatically neutral. A significant shift toward WTR astigmatism occurred postoperatively. At 6 weeks, 48.3% of eyes had WTR astigmatism and 23.0% had ATR astigmatism. At 12 months, 43.8% had WTR astigmatism and 25.8% had ATR astigmatism. Vector analysis revealed a mean surgically induced astigmatism (SIA) of 1.17 D at 6 weeks and 1.04 D at 12 months. The side of the incision significantly affected SIA. At 6 weeks, temporal incisions yielded a mean SIA of 0.74 D and the nasal incisions, of 1.65 D. This trend in SIA persisted at 12 months: 0.71 D for temporal incisions and 1.41 D for nasal incisions. Conclusions: Cataract surgery using a horizontal clear corneal incision induced WTR astigmatism 6 weeks and 12 months postoperatively. Temporal incisions induced significantly less astigmatism than nasal incisions.

Original languageEnglish (US)
Pages (from-to)418-423
Number of pages6
JournalJournal of Cataract and Refractive Surgery
Volume30
Issue number2
DOIs
StatePublished - Feb 2004
Externally publishedYes

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Astigmatism
Nose
Cataract
Baltimore
Phacoemulsification
Intraocular Lenses

ASJC Scopus subject areas

  • Ophthalmology

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Astigmatism outcomes of horizontal temporal versus nasal clear corneal incision cataract surgery. / Barequet, Irina S.; Yu, Edward; Vitale, Susan; Cassard, Sandra; Azar, Dimitri T.; Stark, Walter J.

In: Journal of Cataract and Refractive Surgery, Vol. 30, No. 2, 02.2004, p. 418-423.

Research output: Contribution to journalArticle

Barequet, Irina S. ; Yu, Edward ; Vitale, Susan ; Cassard, Sandra ; Azar, Dimitri T. ; Stark, Walter J. / Astigmatism outcomes of horizontal temporal versus nasal clear corneal incision cataract surgery. In: Journal of Cataract and Refractive Surgery. 2004 ; Vol. 30, No. 2. pp. 418-423.
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abstract = "Purpose: To compare the short- and long-term astigmatism outcomes after cataract surgery using temporal clear horizontal corneal incisions and nasal horizontal clear corneal incisions. Setting: Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA. Methods: This retrospective study included a consecutive series of eyes having phacoemulsification with implantation of a 6.0 mm foldable acrylic intraocular lens through a 3.5 mm horizontal clear corneal incision at 180 degrees (temporal incision in right eyes, nasal incision in left eyes). Astigmatism was measured by keratometry readings before surgery and 6 weeks and 12 months postoperatively. Results: The mean preoperative astigmatism in the 178 eyes (94 right, 84 left) of 161 patients was 0.78 diopter (D); 54.5{\%} of eyes had against-the-rule (ATR) astigmatism, 22.5{\%} had with-the-rule (WTR) astigmatism, and 14.0{\%} were astigmatically neutral. A significant shift toward WTR astigmatism occurred postoperatively. At 6 weeks, 48.3{\%} of eyes had WTR astigmatism and 23.0{\%} had ATR astigmatism. At 12 months, 43.8{\%} had WTR astigmatism and 25.8{\%} had ATR astigmatism. Vector analysis revealed a mean surgically induced astigmatism (SIA) of 1.17 D at 6 weeks and 1.04 D at 12 months. The side of the incision significantly affected SIA. At 6 weeks, temporal incisions yielded a mean SIA of 0.74 D and the nasal incisions, of 1.65 D. This trend in SIA persisted at 12 months: 0.71 D for temporal incisions and 1.41 D for nasal incisions. Conclusions: Cataract surgery using a horizontal clear corneal incision induced WTR astigmatism 6 weeks and 12 months postoperatively. Temporal incisions induced significantly less astigmatism than nasal incisions.",
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T1 - Astigmatism outcomes of horizontal temporal versus nasal clear corneal incision cataract surgery

AU - Barequet, Irina S.

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AU - Azar, Dimitri T.

AU - Stark, Walter J.

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N2 - Purpose: To compare the short- and long-term astigmatism outcomes after cataract surgery using temporal clear horizontal corneal incisions and nasal horizontal clear corneal incisions. Setting: Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA. Methods: This retrospective study included a consecutive series of eyes having phacoemulsification with implantation of a 6.0 mm foldable acrylic intraocular lens through a 3.5 mm horizontal clear corneal incision at 180 degrees (temporal incision in right eyes, nasal incision in left eyes). Astigmatism was measured by keratometry readings before surgery and 6 weeks and 12 months postoperatively. Results: The mean preoperative astigmatism in the 178 eyes (94 right, 84 left) of 161 patients was 0.78 diopter (D); 54.5% of eyes had against-the-rule (ATR) astigmatism, 22.5% had with-the-rule (WTR) astigmatism, and 14.0% were astigmatically neutral. A significant shift toward WTR astigmatism occurred postoperatively. At 6 weeks, 48.3% of eyes had WTR astigmatism and 23.0% had ATR astigmatism. At 12 months, 43.8% had WTR astigmatism and 25.8% had ATR astigmatism. Vector analysis revealed a mean surgically induced astigmatism (SIA) of 1.17 D at 6 weeks and 1.04 D at 12 months. The side of the incision significantly affected SIA. At 6 weeks, temporal incisions yielded a mean SIA of 0.74 D and the nasal incisions, of 1.65 D. This trend in SIA persisted at 12 months: 0.71 D for temporal incisions and 1.41 D for nasal incisions. Conclusions: Cataract surgery using a horizontal clear corneal incision induced WTR astigmatism 6 weeks and 12 months postoperatively. Temporal incisions induced significantly less astigmatism than nasal incisions.

AB - Purpose: To compare the short- and long-term astigmatism outcomes after cataract surgery using temporal clear horizontal corneal incisions and nasal horizontal clear corneal incisions. Setting: Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA. Methods: This retrospective study included a consecutive series of eyes having phacoemulsification with implantation of a 6.0 mm foldable acrylic intraocular lens through a 3.5 mm horizontal clear corneal incision at 180 degrees (temporal incision in right eyes, nasal incision in left eyes). Astigmatism was measured by keratometry readings before surgery and 6 weeks and 12 months postoperatively. Results: The mean preoperative astigmatism in the 178 eyes (94 right, 84 left) of 161 patients was 0.78 diopter (D); 54.5% of eyes had against-the-rule (ATR) astigmatism, 22.5% had with-the-rule (WTR) astigmatism, and 14.0% were astigmatically neutral. A significant shift toward WTR astigmatism occurred postoperatively. At 6 weeks, 48.3% of eyes had WTR astigmatism and 23.0% had ATR astigmatism. At 12 months, 43.8% had WTR astigmatism and 25.8% had ATR astigmatism. Vector analysis revealed a mean surgically induced astigmatism (SIA) of 1.17 D at 6 weeks and 1.04 D at 12 months. The side of the incision significantly affected SIA. At 6 weeks, temporal incisions yielded a mean SIA of 0.74 D and the nasal incisions, of 1.65 D. This trend in SIA persisted at 12 months: 0.71 D for temporal incisions and 1.41 D for nasal incisions. Conclusions: Cataract surgery using a horizontal clear corneal incision induced WTR astigmatism 6 weeks and 12 months postoperatively. Temporal incisions induced significantly less astigmatism than nasal incisions.

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