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  3. 24. Induction of Post Operative Corneal Astigmatism in Single Step versus Three Steps Corneal Tunnel for Cataract Surgery: A Retrospective Study
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24. Induction of Post Operative Corneal Astigmatism in Single Step versus Three Steps Corneal Tunnel for Cataract Surgery: A Retrospective Study

Muhammad Afzal Bodla1, Ali Afzal Bodla1 and Mishal Tanveer2

ABSTRACT

Objective: Identify the best possible surgical technique in order to have minimum possible unwanted astigmatism, hence reducing the significant symptoms associated. Furthermore to identify the best possible techniques in  reducing surgical trauma, early rehabilitation and better patient satisfaction.

Study Design: retrospective analysis

Place and Duration of Study: This study was conducted at the Bodla Eye Care and Multan Medical and Dental College, Multan from March to August 2018.

Materials and Methods: 65 post phacoemulsification cases was done. Cases were operated by a single surgeon using ALCON 2.8 disposable keratomes. Keratomes were not reusable and intraocular lens of choice was ALCON AcrySof IQ SN60WF, with optic size of 6.0 and overall length of 13.0 mm. Intraocular lenses were inserted using ALCON approved Monarch IOL delivery cartridges.

Results: Out of 65 eyes there were 38 male (58.4%) and 27 female (41.5%) patients. From clinical notes grades of nuclear sclerosis were gathered at the time of presentation which was Grade-1 nuclear sclerosis in (1 eyes), Grade -2, (17 eyes), Grade-3, (33 eyes), Grade-4 (11 eyes), Grade-5 (3 eyes). Preoperative visual acuity was found to be 6/12 or better in 4 (6.1%), between 6/18 to 6/36 in 48 (73.8%) and 13 eyes (20%) had a preoperative visual acuity of counting fingers to perception of light. Post operative visual acuity improved between 6/6 to 6/12 in 56 eyes and in 9 eyes, improved to 6/18 to 6/60. from 1st week, 8th week, 12th week, and 24th week clinic visit.

Conclusion: This study included 65 eyes that had phacoemulcifaction with posterior chamber intraocular lens implant. All patients had a single step, straight corneal incision using standard single use keratome. A gradual reduction in post operative corneal astigmatism was observed over a period of twelve months as per data gathered. Astigmatic error ranged from 0.00 to -0.50 Dcyl in 26 eyes ( 40%), 0.50 to -1.00Dcyl in 25 eyes (38.4%) , -1.00 to -1.50Dcyl in 14 eyes (21.5%). Comparing to data available on two or three step corneal incisions, it was found at par infact significant less astigmatic error was noticed. Furthermore on the part of surgeon visualisation of intraocular structures is better and allows greater access to the incision.

Key Words: Corneal Astigmatism, Phacoemulsification, Refractive Error.

Citation of articles: Bodla MA, Bodla AA, Tanveer M. Induction of Post Operative Corneal Astigmatism in Single Step versus Three Steps Corneal Tunnel for Cataract Surgery: A Retrospective Study. Med Forum 2018;29(11):87-90.