Suhas Shamrao Sarawade, Shraddha Dnyaneshwar Mahadik
BACKGROUND Cataract surgery has become one of the most common and successful procedures in ophthalmology. Cataract surgery is no more a blind rehabilitation surgery. Good post-operative vision is considered norm. Surgically induced Astigmatism (SIA) is one of the important factors that hampers post-operative good visual outcome. One of the goals of modern cataract surgery is to reduce SIA, a factor that may reduce VA and affects the quality of vision. Aims and objectives- 1. To compare the two incisions as a function of location with regard to postoperative astigmatism and type of astigmatism. 2. Comparison of postoperative uncorrected visual acuity and postoperative best corrected visual acuity in both the groups. MATERIALS AND METHODS In this prospective, interventional, hospital based, comparative study 100 patients were studied. The patients were randomly assigned to any of the two groups having 50 patients each. The patients in group A underwent manual small incision cataract surgery (MSICS) with superior incision and the patients in group B underwent MSCICS with the temporal incision. The patients were examined on postoperative days 1st, 7th, 4th week, 6th week and 3rd month. The uncorrected and best corrected visual acuity was recorded, slit-lamp, autorefractometer and keratometry examinations were done. RESULTS After 6 weeks postoperatively, out of 50 patients in superior scleral incision group, 64% patients had ATR astigmatism and 28% patients had WTR astigmatism, in temporal scleral incision group 58% of the patients had WTR astigmatism and 26% had ATR astigmatism. The SIA in temporal incision group was significantly less (0.63 ± 0.42 D) than the superior incision group (1.20 ± 0.50 D) after 6 weeks postoperatively (t=6.43, p<0.01). Postoperative uncorrected visual acuity was better with temporal incision than superior incision, although there was no difference in best corrected visual acuity in both the groups. CONCLUSION This study reveals that temporal approach MSICS produces less postoperative astigmatism and has manifold advantages over superior incision MSICS with excellent visual outcome.
