16. To Evaluate the Difference in Astigmatism on Keratometry Resulting from Temporal and Superior Corneal Incisions During Phacoemulsification
Mohammad Ashraf , Nazullah, Samina Kareem, Mohammad Rafique and Sohail
ABSTRACT
Objective: To compare the average change in keratometry's medically induced astigmatism between corneal incisions made laterally vs laterally for phacoemulsification.
Study Design: Randomized Controlled Trial
Place and Duration of Study: This study was conducted at the Department of Ophthalmology, Khyber Institute of Ophthalmic Sciences HMC, Peshawar. From 21-07- 2022 to 21-01-2023.
Methods: A cohort of 140 individuals diagnosed with cataracts were assigned to two groups using a random allocation procedure. Patients in group A had a superior corneal incision, whereas patients in group B underwent a temporal incision for phacoemulsification. The keratometry values at baseline and follow-up were collected to calculate the average change in astigmatism between baseline and follow-up.
Results: Across the whole study population, the mean age of the patients was 49.6 + 5.3 years. Patients in group B had a mean age of 50.4 + 4.9 years (p 0.04), compared to 48.9 + 5.8 years in group A. When the sample was divided into groups based on gender, group A had 82.9% men and 17.1% women, whereas group B had 74.3% men and 25.7% women (p 0.217). Group A's mean BMI was 24.9 + 3.8 kg/m2, whereas Group B's mean BMI was 25.2 + 3.7 kg/m2. In groups A and B, the mean baseline BCVA was 0.8 + 0.2 and 0.8 + 0.2, respectively (p 0.858). On keratometry, group A's mean baseline astigmatism was 0.2 + 0.06D, whereas group B's was 0.1 + 0.07 (p 0.614). According to keratometry, group A's mean follow-up astigmatism was 1.2 + 0.2D, whereas group B's was 1.1 + 0.2 (p 0.836). According to keratometry, group A's astigmatism changed by 1.0 + 0.17D and group B's by 1.0 + 0.2 (p 0.707).
Conclusion: In groups with corneal versus temporal incisions, we did not observe a statistically significant difference in the mean change in astigmatism before and after phacoemulsification. We recommend conducting more research with larger sample sizes and accounting for confounders that may have an impact on patients' surgically induced astigmatism following phacoemulsification, as our study was conducted with a smaller sample size and did not account for effect modifiers.
Key Words: Senile Cataract, phacoemulsification, temporal incision superior corneal incision, astigmatism, keratometry.