Surgically Induced Astigmatism after Superior versus Temporal Scleral Incision in Manual Small Incision Cataract Surgery - A One Year Hospital Based Randomised Controlled Trial

Abstract

Background and objectives ABSTRACT Of the total estimated 38 million blind people in the world, nine to 12 million are in India 50 to 80% of these people are blind because of cataract. In addition to the backlog, an additional 3.8 million become blind each year because of cataract. The objective of the present study was evaluate and compare the amount of induced astigmatism after superior and temporal incision in manual small incision cataract surgery ( SICS ) . Methodology The present one year randomized clinical trial study was conducted in the Department of Ophthalmology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum on 100 patients undergoing manual SICS during the period of January 2008 to December 2008. The study was approved by the Ethical and Research Committee of Jawaharlal Nehru Medical College, Belgaum. The patients were assigned randomly into two groups by computer generated table namly Group 1 ( SICS using superior scleral incision) and Group 2 ( SICS using temporal scleral incision) . Results In group A with superior incision the average SIA was 0.96 ± 0.68 and in group B with temporal incision the average SIA was 0.65 ± 0.59. The comparison between mean of the two groups using unpaired ‘t’ test was statistically significant ( p=0.020 ) indicating group B had less SIA. Superior incision induced ATR ( 58% ) and temporal incision induced WTR ( 68% ) . VIII Conclusion and interpretation In the present study the visual rehabilitation was similar in both the groups. The UCVA was better in temporal incision as compared to superior incision group. In conclusion, temporal incision is evidently better than superior incision in minimizing surgically induced astigmatism.