Correction of with-the-rule Astigmatism by Superior Clear Corneal Incision and Transverse Keratotomy in Cataract Surgery

Seo, Jong Mo; Lee, Jin Hak

Abstract

PURPOSE: The effect of superior clear corneal incision and transverse astigmatic keratotomy on the with-the-rule astigmatism in sutureless, small incision cataract surgery was evaluated.
METHODS
The postoperative keratometric changes were evaluated in 18 eyes with more than 1.4 diopter (D) of preoperative with-the-rule astigmatism, having sutureless, superior clear corneal incision phacoemulsification. Five eyes over 2.8 D with-the-rule astigmatism also had transverse corneal relaxing incision. Keratometric readings were done within 1 month preoperatively, 1 day and 2 months postoperatively and the changes were statistically analyzed. Simple subtraction method and Cravy method were used for the analysis of astigmatic changes.
RESULTS
The mean astigmatism showed decreasing trend, 2.08, 2.25, 1.12 D, within preoperative 1 month, at postoperative 1 day and 2 months respectively and 3.70, 2.48, 2.06 D respectively when transverse keratotomy was added. The reduction of astigmatism was statistically significant at postoperative 2 months (P<0.05; Wilcoxon rank-sum test) and it was more significant with transverse astigmatic keratotomy (P<0.05, Mann-Whitney U test).
CONCLUSIONS
The with-the-rule astigmatism over 1.40 D could be reduced in cataract surgery by sutureless, superior clear corneal incision and transverse corneal relaxing keratotomy.