Intraoperative arcuate transverse keratotomy with phacoemulsification.

Abstract

PURPOSE:

To evaluate the efficacy of paired intraoperative arcuate transverse keratotomy at a 7-mm-diameter zone along with a 3.5-mm clear corneal phaco tunnel in the steeper axis to correct pre-existing astigmatism.

METHODS:

A prospective randomized case-control study was conducted on 34 eyes of 28 patients with immature senile cataract. They were divided into two groups; in one group (17 eyes) intraoperative arcuate keratotomy was coupled with phacoemulsification in the steeper meridian (arcuate keratotomy group; mean preoperative astigmatism 2.28 +/- 0.89 D) and the other group (17 eyes) phacoemulsification was performed in the steeper meridian without arcuate keratotomy (control group; mean preoperative astigmatism 2.04 +/- 0.50 D). The patients were examined at 1 day, and 1, 4, and 8 weeks postoperatively. Correction of keratometric astigmatism, surgically induced refractive changes, magnitude and axis of cylinder, spherical equivalent refraction, with and against the wound change, and coupling ratio were evaluated.

RESULTS:

Mean reduction in keratometric astigmatism in the keratotomy group was 1.26 +/- 0.54 D (P = .0067) and in the control group was 0.48 +/- 0.60 D (P = .0423). The difference in reduction of keratometric astigmatism between the two groups was statistically significant (P = .0296). Surgically induced refractive change at 8 weeks follow-up was 2.15 +/- 1.13 D in the keratotomy group and 1.50 +/- 1.32 D in the control group (P = .046). Coupling ratio was -1.10 +/- 0.43 in the keratotomy group at 8 weeks after surgery while the control group was -0.82 +/- 0.38.

CONCLUSION:

A combination of intraoperative arcuate keratotomy with steep axis phacoemulsification incision is more effective than steep axis phacoemulsification incision alone in reducing pre-existing astigmatism.

• Authors: Jeewan S Titiyal, Krishna P Baidya, Rajesh Sinha, Manotosh Ray, Namrata Sharma, Rasik B Vajpayee, Vijay K Dada
• Journal: Journal of refractive surgery (Thorofare, N.J. : 1995) (J Refract Surg) 2002 Nov-Dec Vol. 18 Issue 6 Pg. 725-30 ISSN: 1081-597X [Print] United States
• PMID: 12458867 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Topics

• Aged
• Astigmatism (complications, physiopathology, surgery)
• Case-Control Studies
• Cataract (complications)
• Cataract Extraction (methods)
• Control Groups
• Cornea (surgery)
• Female
• Humans
• Male
• Middle Aged
• Ophthalmologic Surgical Procedures
• Phacoemulsification
• Postoperative Period
• Prospective Studies
• Refraction, Ocular