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Volume 35, Issue 9, Pages 1555-1562 (September 2009)


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Astigmatic neutrality in biaxial microincision cataract surgery

Claude Kaufmann, MD, Amirtharajan Krishnan, FRCS(Ophth), John Landers, FRANZCO, PhD, Adrian Esterman, AStat, PhD, Michael A. Thiel, MD, PhD, Michael Goggin, FRCSI(Ophth), MSCorresponding Author Informationemail address

Received 18 March 2009; received in revised form 24 March 2009; accepted 26 March 2009.

Purpose

To assess the astigmatic effect of biaxial microincision cataract surgery (MICS) with insertion of an UltraChoice 1.0 Rollable Thinlens intraocular lens (IOL) in a sufficiently powered controlled study.

Setting

Queen Elizabeth Hospital, South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, Australia.

Methods

Consecutive patients having biaxial MICS were evaluated prospectively. Keratometry was performed preoperatively and postoperatively. Vector analysis of the alteration in the keratometric cylinder was compared with that in control eyes not having surgery but having keratometry over a similar time frame.

Results

There were 76 eyes in the surgical group and 74 in the control group. The right-hand incision used for IOL insertion had a mean external opening width of 2.00 mm and a mean internal width of 1.89 mm. The left-hand incision measured a mean of 1.49 mm and 1.46 mm, respectively. There was no statistically significant difference between the surgical group and the routine variability in keratometry in the untreated control group in surgically induced astigmatism (surgical group, 0.57 diopter [D] ± 0.05 [SEM]; control group, 0.54 ± 0.06 D; P =.660) or the degree of mean calculated flattening effect at the right-hand incision (0.01 ± 0.06 D and −0.05 ± 0.05 D, respectively; P = .405) or at the left-hand incision (−0.06 ± 0.05 D and 0.03 ± 0.06 D, respectively; P = .283).

Conclusion

Biaxial MICS with insertion of IOL through a temporal incision of 2.0 mm offers prospects of astigmatic neutrality in cataract surgery.

From the Departments of Ophthalmology, University of Zurich (Kaufmann, Thiel), Zurich, Switzerland, and South Australian Institute of Ophthalmology (Krishnan, Landers, Goggin), University of Adelaide, and the School of Nursing and Midwifery (Esterman), University of South Australia, Adelaide, Australia

Corresponding Author InformationCorresponding author: Dr. Michael Goggin, The Queen Elizabeth Hospital & Health Service, Department of Ophthalmology, 7A Main Building, 28 Woodville Road, Woodville South SA 5011, Australia.

 No author has a financial or proprietary interest in any material or method mentioned.

PII: S0886-3350(09)00500-8

doi:10.1016/j.jcrs.2009.03.048


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