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Surgically Induced Astigmatism following coaxial phacoemulsification with 2.2, 2.4 and 2.8mm incisions: A prospective, randomized clinical trial Vaishali.

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Presentation on theme: "Surgically Induced Astigmatism following coaxial phacoemulsification with 2.2, 2.4 and 2.8mm incisions: A prospective, randomized clinical trial Vaishali."— Presentation transcript:

1 Surgically Induced Astigmatism following coaxial phacoemulsification with 2.2, 2.4 and 2.8mm incisions: A prospective, randomized clinical trial Vaishali Vasavada, MS #, Viraj A. Vasavada, MS #, Lajja Shastri, MS #, Abhay R. Vasavada, MS, FRCS(England) #, Shail A. Vasavada, DO #, Warren Hill, MD* # Iladevi Cataract & IOL Research Centre, Ahmedabad, India The authors have no financial interest in this presentation * East Valley Ophthalmology, Arizona, USA

2 Significantly less astigmatism is induced with a 2.0mm incision as compared to a 3.0mm incision Induced astigmatism with 2.2- and 3.0-mm coaxial phacoemulsification incisions. J Refract Surg Jan;25(1):21-4 Masket S, Wang L, Belani S. Induced astigmatism, focal wound related flattening of the peripheral cornea, and corneal surface irregularity were significantly less after coaxial MICS (2 mm) than after SICS (2.65mm) Postoperative corneal shape changes : Micro-incision versus small-incision cataract surgery. J Cataract Refract Surg. 2009; 35 : Hayashi K, Yoshida M, Hayashi H.

3 To compare surgically induced astigmatism following coaxial phacoemulsification through 2.2, 2.4 and 2.8mm clear corneal incisions Aim

4 Materials and Methods Study Design : Prospective, randomized, controlled study Study Population : 120 eyes of 120 patients undergoing coaxial phacoemulsification for age-related cataracts Single surgeon (ARV) Standardized surgical technique : Coaxial phacoemulsification performed using 0.9mm ABS mini- flared 45 degree Kelman tip IOL implantation performed using C cartridge : 2.8mm incision D cartridge : 2.2 and 2.4mm incision

5 Patients randomized to one of three groups : Group I : 40 eyes of 40 patients 2.2 mm temporal, clear corneal incision Materials and Methods Group II : 40 eyes of 40 patients 2.4 mm temporal, clear corneal incision Group III: 40 eyes of 40 patients 2.8 mm temporal, clear corneal incision

6 Preoperatively : Manual Keratometry Postoperatively : Manual Keratometry : 1 week, 1 month and 3 months follow-up Best corrected visual acuity (BCVA) 1 month and 3 months follow-up Unaided visual acuity (UAVA) 1 week, 1 month and 3 months follow-up Observations

7 Surgically Induced Astigmatism : Magnitude and axis of surgically induced astigmatism calculated by vector analysis based on the manual keratometric values - Magnitude of surgically induced astigmatism : -Compared between the three groups at 1 week, 1 month and 3 months postoperatively - Axis of surgically induced astigmatism : -Compared between the three groups at 1 week, 1 month and 3 months postoperatively - UAVA and BCVA also compared between the groups * Kruskal – Wallis test used for statistical analysis Observations

8 Magnitude of Surgically Induced Astigmatism 2.2mm2.4mm2.8mmP value* 1 week month months * P value of <0.05 considered statistically significant Results

9 Axis of Surgically Induced Astigmatism 2.2mm2.4mm2.8mmP value* 1 week month months * P value of <0.05 considered statistically significant Results

10 Unaided Visual Acuity - LogMAR 2.2mm2.4mm2.8mmP value* 1 week month months * P value of <0.05 considered statistically significant Results

11 Best Corrected Visual Acuity - LogMAR 2.2mm2.4mm2.8mmP value* 1 month months Results * P value of <0.05 considered statistically significant

12 There was no statistically significant difference in the magnitude or the axis of surgically induced astigmatism when performing coaxial phacoemulsification with 2.2, 2.4 or 2.8 mm incisions Conclusion


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