SITE OF INCISION FOR SUTURELESS CATARACT- SURGERY ACCORDING TO PREOPERATIVE ASTIGMATISM

Purpose To compare surgically induced astigmatism, postoperative astig matism and uncorrected visual acuity after cataract surgery depending on the site of a 4 mm sutureless incision (superior scleral or corneal temporally and on the preoperative astigmatism. Methods According to preoperative astigmatism and to the site of incision 4 groups have bee n distinguished. Group I: with-the-rule preoperative astigmatism and s uperior scleral incision, group II : with-the -rule preoperative astig matism and corneal temporal incision, group III : against-the-rule pre operative astigmatism and superior scleral incision, group IV: against -the-rule preoperative astigmatism and temporal incision. The patients had a preoperative and postoperative (Day 1, 8, 30, 180, 360) keratom etry. Surgically induced astigmatism, preoperative and postoperative a stigmatism have been expressed according to Naeser method. The uncorre cted visual acuity at Day 30 has been compared in each group. Results Preoperative astigmatism was similar in the four groups. Surgically in duced astigmatism was - 0.18 diopter (D) at day 30 and -0.41 D ar day 360 for the scleral incisions and + 0,60 D ar day 30 and + 0.33 D al. day 360 for the temporal incisions. The postoperative astigmatism was + 0.5 D at day 30 and + 0.27 al day 360 for the group I and + 1.22 D a r day 30 and + 0.95 D at day 360 for group II. There was no statistica l difference in the uncorrected visual acuity. Postoperative astigmati sm tvas -0.8 D ar clay 30 and -1.03 D a; day 360 in group III and -0.0 4 D at day 30 and -0.31 D at day 360 in group IV. The visual acuity wa s significantly better in group IV than in group III. Conclusion In ca ses of preoperative with-the-rule astigmatism less than or equal to 0. 75 D the two sires of incisions are possible. In cases oi WTR astigmat ism over 0.75 D we perform a superior-scleral approach. In cases of ag ainst-the-rule astigmatism the temporal incision is the only one to co nsider.