The Comparison of Clinical Results of Medial Clear Corneal Incision with Lateral Clear Corneal Incision in Cataract Surgery

Kim, Kwang Soo; Cho, Hee Tae

Abstract

In temporal clear corneal incision cataract surgery, it is essential to change the equipment and personnel between right eye and left eye. To obtain an advantages of clear corneal incision without going through the hassles and same effect of postoperative astigmatism and visual acuity, we sat at 10 o`clock orientation on patient`s head(right handed surgeon)and performed lateral clear corneal incision on the right eye and medial clear corneal incision on the left eye. Temporal clear corneal incision in right eye(Group 1)and medial clear corneal incision in left eye(Group 2)were performed in randomly selected 20 eyes in each group by one surgeon between June 1997 and October 1997 at Dongguk University Medical Center. Preoperative corneal astigmatism , surgically induced corneal astigmatism and changes of visual acuity were analyzed at 1 week, 2 weeks, 4 weeks, 2 months, 3 and 6 months postoperatively using corneal videokeratography(EYESYS Technology)and visual acuity chart projector(Topcon ACP-7). Postoperative uncorrected visual acuities were 20/40 or better in 75%(15 eyes)in group 1 and 70%(14 eyes)in group 2. In preoperative corneal astigmatism, there was no statistical significance between the two groups (P>0.05)(Group 1: 0.58+/-0.28D, Group 2: 0.59 +/-0.17D). In surgically induced corneal astigmatism, we found there was statistically significant difference between the two groups(P<0.05)(Group 1: 1. 26+/-0.61D, Group 2: 1. 64+/-0.34D)at 1 week postoperatively, but at 6months postoperatively, there was no statistically significant difference between the two groups(P>0.05)(Group 1: 0.87+/-0.59D, Group 2: 1. 14+/-0.58D). In conclusion, medial clear corneal incision did not need to change the personnel and equipment from case to case and the nose didn`t get in the way in medial approach. We consider that medial clear corneal incision is recommendable procedure because there were no significant differences in postoperative visual acuity and surgically induced astigmatism at 6 months postoperatively between the two groups.