Change in Corneal Astigmatism After Phacoemulsification with Rigid Intraocular Lens Implantation

Change in Corneal Astigmatism After Phacoemulsification

Abstract

Phacoemulsification with lens implant is the preferred method of cataract extraction nowadays. In resource-deficient settings, rigid polymethyl methacrylate (PMMA) lenses are implanted which require enlargement of corneal incision to 5.5mm. Objectives: We conducted this study to evaluate the effect of corneal incisions secured with a single suture on corneal astigmatism after routine cataract surgery. Methods: It was a quasi-experimental study conducted at tertiary care hospitals. Sixty patients were studied and preoperative visual acuity and keratometry readings were noted. After standard phacoemulsification, a 5.5mm rigid PMMA lens was implanted in the bag, and the corneal incision was sutured using a single central 10/0 nylon suture. Visual acuity and keratometry readings were noted on 1st postoperative day, 1-week postoperatively, and 6-weeks postoperatively and compared with pre-operative values. Results: The mean age was 59.27 ± 10.72 (range: 46 – 78) years. There were 32 (53.3%) males and 28(46.7%) females in the study. The mean preoperative keratometry reading was 0.89 ± 0.70 D, and the mean first-day postoperative cylinder was 1.94 ± 0.98 D (p < 0.05). The mean astigmatism at the 6th week postoperatively was 0.96 ± 0.65 D, and its comparison with the pre-operative astigmatism was statistically not significant (p > 0.05). Surgically induced astigmatism was found to be 0.07 diopters. Almost 60% of the patients achieved uncorrected 6/7.5 or better visual acuity, and more than one-third of patients achieved 6/6 best corrected visual acuity six weeks after the cataract surgery using the described technique. Conclusions: Phacoemulsification with 5.5mm PMMA IOL with a central single suture is an effective procedure for postoperative astigmatism and visual outcome.