Korean J Ophthalmol.  2014 Apr;28(2):130-137. 10.3341/kjo.2014.28.2.130.

Comparison of Surgically-induced Astigmatism after Combined Phacoemulsification and 23-Gauge Vitrectomy: 2.2-mm vs. 2.75-mm Cataract Surgery

• Kim YK
• Kim YW
• Woo SJ
• Park KH

• KMID: 1792106
• DOI: http://doi.org/10.3341/kjo.2014.28.2.130

Abstract

PURPOSE
The 2.2-mm microincision cataract surgery and small-gauge vitrectomy system is known to result in less surgically-induced astigmatism (SIA) in comparison to conventional surgical methods. We compared the amounts of SIA after combined phacoemulsification and 23-gauge transconjunctival sutureless vitrectomy (23G-TSV) using the 2.2-mm microincision and 2.75-mm standard incision methods.
METHODS
We studied 59 patients (61 eyes) who underwent combined phacoemulsification and 23G-TSV from November 2008 to September 2012. Twenty-eight patients (28 eyes) underwent 2.2-mm microincision coaxial phacoemulsification, and 31 patients (33 eyes) underwent 2.75-mm standard incision phacoemulsification. SIA was evaluated using Naeser's polar method with the simulated keratometric values obtained from corneal topography. Preoperative and 1-week and 1-month postoperative KP (Naeser's polar value along the specific axis) and DeltaKP values were compared between the 2.2-mm microincision and 2.75-mm standard incision groups.
RESULTS
One week after surgery, both groups exhibited similar amounts of SIA (-DeltaKP[120], 0.40 +/- 0.41 vs. 0.51 +/- 0.56 diopters [D]; p = 0.390). One month after surgery, however, the amount of SIA was significantly smaller in the 2.2-mm microincision group as compared to the 2.75-mm standard incision group (-DeltaKP[120], 0.31 +/- 0.54 vs. 0.56 +/- 0.42 D; p = 0.045).
CONCLUSIONS
In combined phacoemulsification with 23G-TSV, 2.2-mm microincision coaxial phacoemulsification induces less SIA than does 2.75-mm standard coaxial phacoemulsification.

Keyword

Microincision; Phacoemulsification; Surgically-induced astigmatism; Transconjunctival sutureless vitrectomy

MeSH Terms

Aged
Astigmatism/diagnosis/*etiology
*Cataract
Cornea/surgery
Corneal Topography/methods
Female
Humans
Lens Implantation, Intraocular/*adverse effects/methods
Male
Middle Aged
Phacoemulsification/*adverse effects/methods
Postoperative Complications/diagnosis/etiology
Sclera/surgery
Vitrectomy/*adverse effects/instrumentation/methods

Figure

• 

  Fig. 1 Serial changes in KP(120) in the 2.2-mm microincision group (A, n = 28) and the 2.75-mm standard incision group (B, n = 33). A p-values was calculated using the paired t-test.

• 

  Fig. 2 Comparison of surgically-induced astigmatism (represented as ΔKP[120]) between the 2.2-mm microincision group and the 2.75-mm standard incision group. A p-values was calculated using Student's t-test.

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