Efficacy and Safety of Opposite Clear Corneal Incision to Reduce Pre-existing Astigmatism After Phacoemulsification - A Prospective Study
Shavina Garg1, Balbir Singh2, PL Jindal3, YN Mathur4, Anand Aggarwal1*, Kamlinder Kaur1, Indu Khosa1 and Ravneet Pannu1
1Department of Ophthalmology, Government Medical College, Patiala, India
2Director, Guru Teg Bahadur Superspecialty Eye Hospital, Patiala and Member Legislative Assembly, Vidhan Sabha Punjab, Chandigarh, India
3Chief Medical Officer, Dera Hospital, Beas, India
4Secretary, Maharaj Jagat Singh Medical Relief Society (MJMRS), Beas, India
*Corresponding Author: Anand Aggarwal, Cornea, Glaucoma and Refractive Surgery Services, Department of Ophthalmology, Government Medical College, Patiala, India.
April 27, 2022; Published:
Design: This was a comparative, prospective, randomized study.
Setting: Department of Ophthalmology, Government Medical College, Patiala, Punjab.
Purpose: To compare the efficacy and safety of Opposite Clear Corneal Incision to reduce pre-existing astigmatism after phacoemulsification in tertiary Eye Care centre of India.
In this prospective, comparative study 160 patients planned for phacoemulsification were divided into 2 groups. Group A received a foldable IOL through 3.2 mm clear corneal incision made on the steeper meridian along with a 3.2 mm opposite clear corneal incision in an attempt to reduce pre-existing astigmatism. Group B received a foldable IOL through a single clear corneal incision made on the steeper meridian. The preoperative and postoperative data at day 7, 1 month, 3 months and 6 months, on UCVA, BCVA, astigmatism was compared between the groups.
Results: A total of 160 patients were enrolled in the study. These patients were divided into 2 groups with 80 patients in each group. The mean preoperative astigmatism was 1.40 +/- 0.31 in group A which reduced to 0.61 +/- 0.14 D after 6 months. The mean preoperative astigmatism was 1.34 +/- 0.26 D in group B, which reduced to 0.98 +/- 0.18 D after 6 months of follow up. The average mean astigmatic reduction in group A and B was 0.79 D and 0.30 D respectively. There was a significant difference in mean astigmatism between both the groups after 6 months of follow up (p Value < 0.05). 95% of patients had uncorrected visual acuity between 6/6 - 6/9 in group A whereas 55% patients had UCVA between 6/6 - 6/9 after 6 months (p Value < 0.05). None of the patients had UCVA less than 6/18 in both groups. The BCVA was between 6/6 - 6/9 in 97.5% and 95% of patients in group A and group B respectively, which showed no significant difference in terms of BCVA.
Conclusion: Being an advancement in refractive lenticular surgery, Opposite Clear Corneal Incision is a safe and cost effective procedure in reducing mild to moderate preexisting corneal astigmatism if reliable preoperative corneal topography readings using pentacam are available. They may be employed during phacoemulsification surgery to further enhance visual outcomes and patient satisfaction.
Keywords: Cataract; Phacoemulsification; Opposite Clear Corneal Incision (OCCI); Clear Corneal Incision (CCI); Astigmatism; Visual Acuity
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