ASTIGMATIC STABILIZATION OF 3.0 MM TEMPORAL CLEAR CORNEAL CATARACT INCISIONS

Purpose: To determine the time needed for corneal shape changes to sta bilize after a laterally oriented, 3.0 mm, unsutured, single-hinge cle ar corneal tunnel cataract incision combined with implantation of a fo ldable acrylic 5.5 mm intraocular lens. Setting: Advanced Vision Care, West Hills, California. Methods: The study comprised 45 patients who had a similar phacoemulsification technique and lens implantation thro ugh an unenlarged 3.0 x 2.5 mm self-sealing temporal clear corneal tun nel incision. Changes in corneal curvature were determined by computer ized videokeratography (corneal topography) prior to surgery and at 1, 2, and 6 weeks after surgery. Simulated keratometry was ascertained f rom topography and analyzed with the Lens-Stat software program. Resul ts: Preoperative corneal cylinder, cylinder axis, and central corneal curvature did not change markedly after surgery. By vector analysis, a pproximately 0.50 diopter (D) of induced cylinder was noted, whereas l ess than 0.25 D of cylinder change was observed in the surgical meridi an. Although statistically similar, there were slight differences betw een the data at 1 and 2 weeks postoperatively. However, the 2 and 6 we ek data were indistinguishable, indicating that the incision method us ed in the study was fully stable within 2 weeks of surgery. Conclusion s The surgical method resulted in stable corneal curvature by 2 weeks after surgery at which time the patient is ready for final spectacle p rescription and can be discharged from acute postoperative ophthalmolo gic care in the absence of complicating factors. The shortened recover y time is beneficial for the patient and has significant potential eff ects on the global costs of cataract rehabilitation and the reimbursem ent schemes for postoperative management.