Corneal incision on steepest meridian in phacoemulsification, could it correct the corneal astigmatism?

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Abstract Introduction: Cataract surgery is regarded as refractive surgery when we are aiming at eliminating corneal astigmatism. So when planning a surgery both spherical and astigmatic components should be taken into account to achieve emmetropia postoperativelyPurpose: Measuring the changes of keratometric reading (K1, K2) after phacoemulsification surgery with planned incision on the steepest meridian in 50 eyes presenting as well with corneal astigmatism checking if this planned incision on steepest meridian could be an effective method or not to decrease the corneal astigmatism.Patients and Methods: A prospective study included 50 eyes of 35 patients that had immature senile cataract with corneal astigmatism more than 1 Diopter. Patients had been recruited and followed up in private eye center in Cairo. Phacoemulsification was done in all cases with placing the main clear corneal incision (0.5 mm from anatomical limbus, 2 mm tunnel length, 3 mm widths) on the steepest meridian. Follow up of patients included UCVA and BCVA at recorded 3 visits; 1 week, 1 month and 3months postoperatively, K-reading changes after 3 months postoperatively detected with pentacam, also, slit-lamp to assess both anterior and posterior segments.Results: this study showed a statistically significant change of front corneal astigmatism of 0.70 D and of 0.07 D of back corneal astigmatism.Conclusion: This method is effective in mild degree corneal astigmatism (up to 1D), while higher degree of astigmatism may need different method of intervention to be more effective in correction of astigmatism. We recommended measuring the IOL power depending on expected postoperative keratometric reading.

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