ON-AXIS CATARACT INCISIONS FOR REDUCING P OSTOPERATIVE-ASTIGMATISM - A PROSPECTIVE-STUDY

Background The no-stitch-technique with deliberate localisation of the cataract incision is a method to reduce the postoperative astigmatism . This prompted us to investigate the postoperative astigmatism with v arying incision localisation; our aim is to achieve a postoperative as tigmatism less than or equal to 1.0 D. Patients and method In this stu dy we controlled 319 eyes of 316 cataract patients. We took into consi deration the preoperative astigmatism and operated in the 12 o'clock o r lateral position. The astigmatism was measured by an ophthalmometer preoperatively, on the first day, after 3-5 months and 8-12 months aft er surgery. Results A preoperative astigmatism of up to less than or e qual to 1.0 D was present in 82.4% of eyes. On the first day after sur gery an astigmatism of less than or equal to 1.0 D was present in 89.3 % of eyes. After 3-5 months postoperatively astigmatism was less than or equal to 1.0 D in 97.2% and in 98.8% after 8-12 months postoperativ ely. 15.7% of patients showed preoperative astigmatism between 1 and 2 D, but only 1.2% after 8-12 months. There was no astigmatism >2.0 D a fter 3-5 months and 8-12 months (preoperative 2%). Conclusions The no- stitch-technique permits to control the postoperative astigmatism with deliberate localisation of the cataract incision. Postoperative astig matism appeared to be stable. We therefore recommend for preoperative ''ATR (Against the rule)-Astigmatism'' (greater than or equal to 1.0 D ) operation in lateral position and for preoperative ''WTR (With the r ule)-Astigmatism'' operation in the 12 o'clock position.