Document Detail

Induced astigmatism after 4 and 6 mm scleral tunnel incision. A randomized study.
MedLine Citation:
PMID:  9527329     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To study the surgically induced astigmatism after phacoemulsification through either a 4 or a 6 mm scleral tunnel incision by using multiple analyses of astigmatism. METHODS: 197 eyes from 186 patients scheduled for phacoemulsification between October 1992 and March 1994 were randomly assigned two different-sized incisions with follow-ups at 1 day, 1 week, 2 weeks, 1 month and 4 months after surgery. The surgically induced astigmatism was evaluated using at each follow-up: 1) The subtraction method, 2) vector analysis, 3) vector decomposition, 4) Cravy's vertical vector, 5) Naeser's polar values, and 6) the algebraic method. RESULTS: By subtraction, without regard to axis, the induced astigmatism 4 months after surgery was +0.04 D and +0.18 D in the 4 mm and the 6 mm incision group, respectively. By vector analysis, the numerical value of the induced cylinder was stable one month after surgery at 0.61 D and 0.77 D in the 4 mm and in the 6 mm group, respectively. However, cylinder orientation was not found stable until 4 months after surgery, where 94% and 96% of the surgically induced astigmatism (vector decomposition) was against-the-wound in the two groups, respectively. By Cravy's method, the mean induced astigmatism changed from -0.08 D to -0.32 D and from -0.42 D to -0.60 D between 1 and 4 months in the 4 mm and the 6 mm group, respectively. Similar values were found with Naeser's method and with the algebraic method. CONCLUSION: We conclude the mean cylinder of the surgically induced astigmatism (vector analysis) to be stable 1 month after phacoemulsification with both the 4 mm and 6 mm scleral tunnel incision. However, the direction of the induced axis (vector decomposition) was still drifting between 1 and 4 months in both groups. These astigmatic changes were adequately described using vector analysis and vector decomposition.
M Dam-Johansen; T Olsen
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta ophthalmologica Scandinavica     Volume:  75     ISSN:  1395-3907     ISO Abbreviation:  Acta Ophthalmol Scand     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-05-08     Completed Date:  1998-05-08     Revised Date:  2008-03-17    
Medline Journal Info:
Nlm Unique ID:  9507578     Medline TA:  Acta Ophthalmol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  669-74     Citation Subset:  IM    
Department of Ophthalmology, Arhus University Hospital, Aarhus C, Denmark.
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MeSH Terms
Astigmatism / etiology*
Cornea / pathology
Follow-Up Studies
Middle Aged
Phacoemulsification / adverse effects*,  methods
Postoperative Complications
Refraction, Ocular
Retrospective Studies
Sclera / surgery*
Suture Techniques*

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