Effect of The Corneal Incision Length Aligned with The Steep Axis on Preoperative Corneal Astigmatism in Eyes Undergoing Phacoemulsification

Mahdy, Reda A.; Ali, Zeiad Mohamed; Ibrahim, Basem Mohamed; Elsayed, Tamer Gamal

doi:10.21608/zumj.2025.348484.3765

Effect of The Corneal Incision Length Aligned with The Steep Axis on Preoperative Corneal Astigmatism in Eyes Undergoing Phacoemulsification

Articles in Press

Document Type : Original Article

Authors

¹ Ophthalmology department, Faculty of medicine, Zagazig university, Zagazig, Egypt

² Zagazig

³ Ophthalmology department, Faculty of Medicine, Zagazig University, Sharkia, Egypt.

⁴ Ophthalmology department , Faculty of medicine, Zagazig university, Zagazig, Egypt

10.21608/zumj.2025.348484.3765

Abstract

Background: To evaluate the effect of corneal incisions length aligned with the steep corneal axis on the preoperative corneal astigmatism, in eyes undergoing phacoemulsification. Methods: A prospective randomized comparative interventional study that was performed on patients ≥ 50 years’ age subjected to phacoemulsification cataract surgery and had corneal astigmatism < 2.50 D. Pentacam was performed to detect the degree of astigmatism. Group I included eyes with long corneal incision (>1.75mm) and Group II included eyes with short corneal incision (<1.75mm) in the steepest meridian (Ks). Three month after surgery, corneal OCT and corneal topography were performed to measure the length of the corneal incision, the postoperative keratometric data and corneal astigmatic changes. Results: The study included 50 eyes (50 patients) treated by phacoemulsification, and were randomly distributed; 25 eyes in each group. There were no significant statistical differences between the two groups regarding the type and values of preoperative astigmatism and the K readings (P>0-05). The mean tunnel length was statistically highly significant more in Group I (1901.1±155um) than in Group II (1418.5±169.3um), (P<0.001). Three months after surgery, there was a statistically highly significant reduction in corneal astigmatism (P<0.001) in both groups, and the reduction was more significant in Group I than in Group II (P<0.05). Conclusion: The corneal incision length aligned with the steepest axis during phacoemulsification not only avoids creation of SIA but also significantly reduces the preoperative corneal astigmatism. A long tunnel corneal incision reduces the preoperative corneal astigmatism more significantly than a short tunnel corneal incision.

Keywords

Main Subjects