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

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.