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Astigmatism: A Cataract Surgeon��?s Nightmare.

Sudhir Hegde K, Rajani Kadri, Vikram MJ, Ajay Kudva, Asha Achar, Devika P, and Vandana Serrao

To analyse the surgically induced astigmatism and its decay with respect to the length of the scleral tunnel incision, the type of astigmatism induced. 200 patients who underwent sutureless small incision cataract surgery at our institute between November 2012 and April 2013 were included in this prospective study. They were randomised into 3 groups. Keratometric values were recorded pre- operatively and post- operatively on day1, 1 week and 6 weeks. All changes of keratometry were recorded, tabulated for each corresponding period and the astigmatism decay for the three types of incisions were calculated using statistically acceptable method. A statistically significant reduction in the number of patients showing with- the- rule astigmatism was noticed at the end of 6 weeks post- operatively. An increase in the number of patients showing against the rule astigmatism was seen. In all the 3 groups, maximum number of patients showed less than 1.0D of surgically induced astigmatism which was calculated using subtraction method. Manual small incision cataract surgery induced an against the rule astigmatic change. A low mean astigmatism was seen in all the three groups, which stabilised by the sixth post- operative week.