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Anales de la Sociedad Mexicana de Oftalmología y Archivos de la Asociación Para Evitar la Ceguera en México

2004, Number 5

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Rev Mex Oftalmol 2004; 78 (5)

Astigmatismo inducido en facoemulsificación con incisiones de 3.0 mm ampliadas a 3.75 mm

Ibáñez-Hernández MÁ, Ramos-Espinoza K

Language: Spanish
References: 25
Page: 245-249
PDF size: 244.83 Kb.


ABSTRACT

Objective: To establish the surgical induced astigmatism after phacoemulsification.
Patients and methods: A prospective, longitudinal and observational study was carried out in 72 patients who underwent phacoemulsification. Clear superior cornea incisions of 3.00 mm enlarged to 3.75 mm were carried out and two types of intraocular lenses (IOL) were implanted: 38 eyes (43%) had an acrylic hydrophobic implant and 50 eyes (57%) hydrogel implant. In all patients visual acuity and keratometries were taken before and after surgery (1st and 6th week).
Results: Age average was 66 years (15 – 84 years). Postoperative visual acuity average was 20/30 or better (78%), 5 eyes presented visual acuity of 20/100 or less due to macular pathology. The average of induced astigmatism in patients with acrylic hydrophobic IOL in the first week was 0.34 D and 0.32 D in the 6Th week. In the patients with hydrogel IOL the induced astigmatism average was 0.31 D in the first week and 0.13 in the 6th week (p = 0.0001). The induced astigmatism for both IOL was 0.17 D.
Conclusions: The small clear cornea incisions of 3.0 mm widen to 3.75 mm induce little postoperative astigmatism (0.17 D).


REFERENCES

  1. Minassian DC, Rosen P, Dart JK, Reidy A, Desai P, Sidhu M, Kaushai S. Extracapsular cataract extraction compared with small incision surgery by phacoemulsification: a randomised trial. Br J Ophthalmol 2001, 85(7):822-829.

  2. Roberts C. Materiales de los lentes intraoculares. Highlights of Ophthalmology 2002, 30(6):19-24.

  3. Uusitalo RJ, Ruusuvaara P, Jarvinen E y col. Early rehabilitation after small incision cataract surgery. Refract Corneal Surg 1993; 9:67-76.

  4. Gutierrez-Carmona. Manual multi-phacofragmentation through a 3.2mm clear corneal incision. J Cataract Refract Surg 2000, 26:1523-1527.

  5. Soon-Phaik C. Postoperative inflammation: extracapsular cataract extraction versus phacoemulsification. J Cataract Refract Surg 1999, 25:1280-1284.

  6. Matsumoto Y, Hara T, Chiba K, Chikuda M. Optimal incision sites to obtain astigmatism-free cornea after cataract surgery with 3.2 mm suturuless incision. J Cataract Refract Surg 2001, 27:1616-1617.

  7. Beltrame G, Salvelat ML, Chizzolini M, Driussi G. Corneal topographic changes induced by different oblique cataract incisions. J Cataract Refract Surg 2001, 27:720-725.

  8. Olson RJ, Crandall AS. Prospective randomized comparison of phacoemulsiication cataract surgery with a 3.2 mm vs a 5.5mm suturuless incision. Am J Ophthalmology 1998, 125(5):612-620.

  9. Oshika T, Nagahara K, Yaguchi S, Emi K, Takenaka H, Tsuboi S y col. Three years prospective, randomized evaluation of intraocular lens implantation through 3.2 and 5.5 mm incisions. J Cataract Refract Surg 1998, 24(4):509-514.

  10. Hayashi K, Hayashi H, Nakao F, Hayashi F. The correlation between incision size and corneal shape changes in suturuless cataract surgery. Ophthalmology 1995, 102(4):550-556.

  11. Levy JH, Pisacano AM, Chadwick K. Astigmatic changes after cataract surgery with 5.1 mm and 3.5 mm suturuless incisions. J Cataract Refract Surg 1994, 20(6):630-633.

  12. Wang J, Chen W, Li J. A dynamic study on the surgically induced astigmatism after phacoemulsification through three different sized scleral tunnel incisions. Chung Hua Yen Ko Tsa Chih 2000, 36(2):91-94.

  13. Lyhne N, Krogsager J, Corydon L, Kjeldgaard M. One-year follow-pof astigmatism after 4.0 mm temporal clear corneal and superior scleral incisions. J Cataract Refract Surg 2000, 26:83-87.

  14. Jacobs BS, Gaynes OD, Pharm D, Deutsch MD. Refractive astigmatism after oblique clear corneal phacoemulsification cataract incision. J Cataract Refrac Surg 1999, 25:949-52.

  15. Akura J, Kaneda S, Hatta S, Matsuura K. Controlling astigmatism in cataract surgery requering relatively large selfsealing incisions. J Cataract Refract Surg 2000, 26(11):1650-1659.

  16. Kohnen S. Effect of temporal and nasal unsutured limbal tunnel incisions on induced astigmatism after phacoemulsification. J Cataract Refract Surg 2002, 28:821-825.

  17. Lever J, Dahan E. Opposite clear corneal incision to correct preexisting astigmatism in cataract surgery. J Cataract Refract Surg 2000, 26:803-805.

  18. Merrian Z. Change on the horizontal and vertical meridians of the cornea after cataract surgery. Trans Am Ophthalmol Soc 2001; 99:187-95.

  19. Nan L, Tang X, Sun H. A comparison of clinical effects beetween phacoemulsification and intraocular lens implantation through “L-shaped” and 3.2 mm scleral tunnel incision. Chung HuaYen Ko Tsa Chih 2002, 38(4):220-223.

  20. XieL, Zhu G, Wang X. Clinical observation of astigmatism induced by corneal incision after phacoemulsification. Chung Hua Yen Ko Tsa Chih 2001, 37(2):108-110.

  21. Gimbel HV, Sun R. Postoperative astigmatism following phacoemulsification with sutured vs unsutured wounds. Can J Ophthalmol 1993; 6:259-262.

  22. Gimbel HV, Rannan M, DeLuca M. Effect of suture material on postperative astigmatism. J Cataract Refract Surg 1992, 18:43-50.

  23. Buratto L. Phacoemulsification: principles and techniques. Slack Inc. P: 4, 306, 307.

  24. Kawano K. Modified corneoscleral incision to reduce postoperative astigmatism after 6 mm diameter intraocular lens implantation. J Catarat Refract Surg 1993; 19:387-392.

  25. Müller-Jensen K, Barlinn B. Long-term astigmatic changes after clear corneal cataract surgery. J Cataract Refract Surg 1997; 25:354-357.




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