STABILITY OF ASTIGMATISM OVER 3 YEARS AFTER CORNEAL STRETCH INCISION

PURPOSE: To assess long-term corneal stability of self-sealing clear c orneal stretch incisions with implantation of 5 mm polymethylmethacryl ate (PMMA) intraocular lenses. METHODS: Two hundred consecutive eyes o f 3500 cataract patients who had capsulorhexis, phacoemulsification, a nd preparation of a 1.5 to 2.0 mm corneal tunnel that had an external width of 4.0 to 4.1 mm and an internal width of 6.5 to 7.0 mm (stretch incision), and implantation of a 5 mm PMMA intraocular lens were eval uated clinically and statistically. Slit-lamp microscopy, keratometry, and corneal topography were performed preoperatively and postoperativ ely after 1 week, 1, 2, and 3 years. RESULTS: The mean surgically indu ced astigmatism following superior corneal incision amounted to 1.59 /- 1.06 D after 3 years; following lateral corneal incision, mean surg ically induced astigmatism was 0.84 +/- 0.68 D. There were no corneal complications in the long-term follow-up study. CONCLUSION: Our 5-year experience shows that the self-sealing clear corneal stretch incision in connection with implantation of a 5 mm polymethylmethacrylate intr aocular lens induces approximately 1.00 D of astigmatism. We prefer th e lateral incision and recommend the superior incision only for high p reoperative with-the-rule astigmatism.