IMPACT OF 2.8MM CLEAR CORNEAL INCISION ON REFRACTIVE OUTCOME IN PHACOEMULSIFICATION PATIENTS

Objective: To determine the keratometric change and resultant post-operative refraction of routine cataract patients, after a clear corneal incision of 2.8mm on the steeper meridian. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital Kharian, from Jul 2017 to Jun 2018. Methodology: A total of 123 cataract patients were included in this study. Pre-operative keratometric readings were compared with post-operative readings, after a clear corneal incision (CCI) of 2.8mm made during phacoemulsification procedure. Opposite clear corneal incision was made in astigmatism over 1 diopter. Results: Patients were monitored for six weeks post-operatively. It showed that a reduction of cylinder (0.81 ± 0.60 vs. 0.92 ± 0.54, p0.035) was present if the incision was at or near the steeper meridian. In 99 patients (80.4%) the astigmatism remained the same or there was a reduction in the power of preoperative cylinder. The remaining 24 patients had either no preoperative astigmatism in 11 patients, (8.94%), or the power of cylinder increased in 13 patients (10.57%) secondary to surgically induced astigmatism (SIA). Temporal clear corneal incision (CCI) made a lesser impact on the surgically induced astigmatism (SIA) than other quadrants. Conclusion: The results confirmed that steeper axis clear corneal incision (CCI) CCI is effective in reduction of post-operative astigmatism. These incisions in conjunction with surgeon’s surgically induced astigmatism (SIA) play an important role in predicting postoperative visual outcome