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A prospective, randomized clinical trial

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Presentation on theme: "A prospective, randomized clinical trial"— Presentation transcript:

1 A prospective, randomized clinical trial
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 * East Valley Ophthalmology, Arizona, USA The authors have no financial interest in this presentation

2 Induced astigmatism with 2. 2- and 3
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. Significantly less astigmatism is induced with a 2.0mm incision as compared to a 3.0mm incision Postoperative corneal shape changes : Micro-incision versus small-incision cataract surgery. J Cataract Refract Surg. 2009; 35 : 233-9 Hayashi K, Yoshida M, Hayashi H. 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)

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

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 Materials and Methods Patients randomized to one of three groups :
Group I : 40 eyes of 40 patients 2.2 mm temporal, clear corneal incision 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 Observations Preoperatively : Manual Keratometry Postoperatively :
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)

7 * Kruskal – Wallis test used for statistical analysis
Observations 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 : UAVA and BCVA also compared between the groups * Kruskal – Wallis test used for statistical analysis

8 Results Magnitude of Surgically Induced Astigmatism
2.2mm 2.4mm 2.8mm P value* 1 week 0.02 1 month 0.4 3 months 0.34 * P value of <0.05 considered statistically significant

9 Results Axis of Surgically Induced Astigmatism
2.2mm 2.4mm 2.8mm P value* 1 week 0.13 1 month 0.4 3 months 0.36 * P value of <0.05 considered statistically significant

10 Results Unaided Visual Acuity - LogMAR
2.2mm 2.4mm 2.8mm P value* 1 week 0.84 1 month 0.04 3 months 0.74 * P value of <0.05 considered statistically significant

11 Results Best Corrected Visual Acuity - LogMAR
2.2mm 2.4mm 2.8mm P value* 1 month 0.25 3 months 0.51 * P value of <0.05 considered statistically significant

12 Conclusion 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

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