Samriti Gupta¹, Balbir Singh², Paavan Kalra³, Anand Aggarwal¹*, Amit Chopra¹, Kamalinder Kaur¹, Chiman Lal¹, Indu Khosa¹, Aman Kalia¹ and Veer Davinder¹

¹Department of Ophthalmology, Government Medical College, Patiala, India
²Member Legislative Assembly and Honorable Health Minister, Vidhan Sabha Punjab, Chandigarh, India
³Director, B R Kalra Eye Hospital, Yamunanagar, Haryana, India

*Corresponding Author: Anand Aggarwal, Cornea, Glaucoma and Refractive Surgery Services, Department of Ophthalmology, Government Medical College Patiala, Punjab, India.

Received: September 02, 2026; Published: September 30, 2026

Abstract

Background: This study was conducted to compare postoperative visual outcomes following superior vs temporal approach phacoemulsification with foldable and non-foldable intraocular lens implantation

Materials and Methods: The study included 260 patients undergoing phacoemulsification with intraocular lens (IOL) implantation, randomly assigned to four groups based on surgical approach and lens type. Group 1 (n = 100) received superior approach phacoemulsification with foldable IOL (6 mm optic), and Group 2 (n = 30) received superior approach with non-foldable IOL (5.25 mm optic). Group 3 (n = 100) underwent temporal approach with foldable IOL and Group 4 (n = 30) underwent temporal approach with non-foldable IOL. Postoperative visual outcomes and astigmatism were assessed at day 7, day 30, and at 3, and 6 months. All data were systematically recorded for subsequent analysis.

Results: The study included four groups with comparable demographics. Preoperatively, most patients had uncorrected visual acuity (UCVA) <6/24. Postoperatively, all groups demonstrated significant improvement, with the majority achieving UCVA of 6/6-6/9 at successive follow-ups. At six months, UCVA of 6/6-6/9 was observed in 78%, 60%, 82%, and 70% of patients in groups 1-4, respectively, without significant intergroup differences (p > 0.05). Best-corrected visual acuity (BCVA) also improved significantly, with 98%, 93.3%, 98%, and 96.7% achieving 6/6-6/9 in groups 1-4 (p > 0.05). Near vision (BCNVA) was comparable among groups (N6: 88%, 83.3%, 89%, 86.7%; p = 0.868).

Preoperative corneal astigmatism was similar across groups (0.68-0.86 D; p > 0.05). Postoperatively, an initial rise in astigmatism was observed, followed by gradual reduction. At six months, mean astigmatism was 0.89, 1.53, 0.68, and 1.02 D for groups 1-4, with significant differences between superior versus temporal approaches and foldable versus non-foldable lenses (p < 0.05 / p < 0.001). Astigmatism reduction remained significant throughout follow-up in groups 1, 2, and 4, while group 3 showed non-significant changes from two months onward.

Conclusion: Both superior and temporal approaches with foldable and non-foldable IOLs resulted in comparable UCVA and BCVA outcomes over the follow-up period. However, a significant difference was observed in terms of postoperative astigmatism. Postoperative astigmatism was found to be comparatively lower in the temporal approach and in eyes implanted with foldable intraocular lenses. Among all groups, the temporal foldable group (Group 3) demonstrated the least surgically induced astigmatism, with values approaching preoperative levels and becoming statistically non-significant from two months onwards.

Keywords: Cataract; Phacoemulsification; Foldable IOL; Non Foldable IOL

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Citation

Citation: Anand Aggarwal., et al. “Comparison of Postoperative Visual Outcomes Following Superior Vs Temporal Approach Phacoemulsification with Foldable and Non-Foldable Intraocular Lens Implantation". Acta Scientific Ophthalmology 9:10 (2026): 19-29.

Copyright

Copyright: © 2026 Anand Aggarwal., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.