Cover Image

Corneal Posterior Curvature Changes After Phacoemulsification Cataract Surgery with 2.75 mm Corneal Incision

Artur Jose SCHMITT, Ana Tereza Ramos MOREIRA, Faruk Abrão Kalil FILHO, Fernanda Piccoli SCHMITT

Abstract


The aim of this study was to evaluate the corneal posterior curvature changes after phacoemulsification cataract surgery, with intraocular lens implantation, with a temporal limbal self-sealing 2.75 millimeters (mm) corneal incision, using a Placido-dual rotating Scheimpflug device. In this prospective intervention study, corneal posterior curvature changes were evaluated in fifty-six patients (56 eyes). All patients underwent corneal tomography using the Galilei G2 (Ziemer Ophthalmic System AG, Port, Switzerland) preoperatively (PRE) and with two weeks (RP15), one month (RP30), and three months (RP90) after phacoemulsification cataract surgery with a temporal limbal self-sealing 2.75 mm incision. Tomographic parameters analyzed in the posterior cornea were the steep curvature (K2), flat curvature (K1), mean curvature (average K), and posterior corneal astigmatism. We did not observe any statistically significant change in the K2, K1, average K, and posterior corneal astigmatism in any postoperative follow-up measurements (RP15, RP30, RP90), showing that the postoperative values tend to be the same as the preoperative ones when measured with the Galilei G2 tomography.  In conclusion, the 2.75 mm temporal limbal self-sealing corneal incision in phacoemulsification cataract surgery does not induce significant changes in the posterior corneal curvature parameters of K2, K1, average K, and astigmatism.


References


Domniz YY, Cahana M, Avni I. Corneal surface changes after pars plana vitrectomy and scleral buckling surgery. J Cataract Refract Surg. 2001;27(6):868-72. doi: 10.1016/s0886-3350(00)00755-0 pmid: 11408133

Macedo BGd, Pereira LSM, Rocha FL, Castro ANBVd. Medo de cair e qualidade de vida em idosos com catarata. Rev Brasil Geriatr Gerontol. 2013;16(3):569-77. doi: 10.1590/s1809-98232013000300014

G. BAILEY. All About Vision. Availeble on June 20, 2019: https://www.allaboutvision.com/es/condiciones/cataratas.htm

Martín JR, Naveros BB, Barrera MF, Reyes J. Cirugía de la catarata: de la extracción extracapsular a la facoemulsificación. Arch Soc Canar Oftalmol. 2002;11:1-4.

Zhang B, Ma JX, Liu DY, Guo CR, Du YH, Guo XJ, et al. Effects of posterior corneal astigmatism on the accuracy of AcrySof toric intraocular lens astigmatism correction. Int J Ophthalmol. 2016;9(9):1276-82. doi: 10.18240/ijo.2016.09.07 pmid: 27672591

De Bernardo M, Zeppa L, Cennamo M, Iaccarino S, Zeppa L, Rosa N. Prevalence of corneal astigmatism before cataract surgery in Caucasian patients. Eur J Ophthalmol. 2014;24(4):494-500. doi: 10.5301/ejo.5000415 pmid: 24366768

Hoffmann PC, Auel S, Hutz WW. Results of higher power toric intraocular lens implantation. J Cataract Refract Surg. 2011;37(8):1411-8. doi: 10.1016/j.jcrs.2011.02.028 pmid: 21703818

Savini G, Naeser K. An analysis of the factors influencing the residual refractive astigmatism after cataract surgery with toric intraocular lenses. Invest Ophthalmol Vis Sci. 2015;56(2):827-35. doi: 10.1167/iovs.14-15903 pmid: 25587061

Klijn S, van der Sommen CM, Sicam VA, Reus NJ. Value of posterior keratometry in the assessment of surgically induced astigmatic change in cataract surgery. Acta Ophthalmol. 2016;94(5):494-8. doi: 10.1111/aos.13003 pmid: 27011060

Tappin MJ, Larkin DF. Factors leading to lens implant decentration and exchange. Eye (Lond). 2000;14 Pt 5:773-6. doi: 10.1038/eye.2000.202 pmid: 11116703

Kucumen RB, Yenerel NM, Gorgun E, Kulacoglu DN, Oncel B, Kohen MC, et al. Corneal biomechanical properties and intraocular pressure changes after phacoemulsification and intraocular lens implantation. J Cataract Refract Surg. 2008;34(12):2096-8. doi: 10.1016/j.jcrs.2008.08.017 pmid: 19027566

Lyhne N, Krogsager J, Corydon L, Kjeldgaard M. One year follow-up of astigmatism after 4.0 mm temporal clear corneal and superior scleral incisions. J Cataract Refract Surg. 2000;26(1):83-7. doi: 10.1016/s0886-3350(99)00323-5 pmid: 10646152

Hoffmann PC, Hutz WW. Analysis of biometry and prevalence data for corneal astigmatism in 23,239 eyes. J Cataract Refract Surg. 2010;36(9):1479-85. doi: 10.1016/j.jcrs.2010.02.025 pmid: 20692558

Wenzel M, Kohnen T, Scharrer A. Ambulate Intraokularchirurgie 2011: Ergebnisse der Umfrage von BDOC, BVA, DGII und DOG. Ophthalmo-Chirurgie. 2012;24:205-14.

Giansanti F, Rapizzi E, Virgili G, Mencucci R, Bini A, Vannozzi L, et al. Clear Corneal Incision of 2.75 mm for Cataract Surgery Induces Little Change of Astigmatism in Eyes with Low Preoperative Corneal Cylinder. Eur J Ophthalmol. 2018;16(3):385-93. doi: 10.1177/112067210601600305

Loffler F, Bohm M, Herzog M, Petermann K, Kohnen T. Tomographic Analysis of Anterior and Posterior and Total Corneal Refractive Power Changes After Femtosecond Laser-Assisted Keratotomy. Am J Ophthalmol. 2017;180:102-9. doi: 10.1016/j.ajo.2017.05.015 pmid: 28549845

Nemeth G, Berta A, Szalai E, Hassan Z, Modis L, Jr. Analysis of surgically induced astigmatism on the posterior surface of the cornea. J Refract Surg. 2014;30(9):604-8. doi: 10.3928/1081597X-20140723-01 pmid: 25068890

Koch DD, Ali SF, Weikert MP, Shirayama M, Jenkins R, Wang L. Contribution of posterior corneal astigmatism to total corneal astigmatism. J Cataract Refract Surg. 2012;38(12):2080-7. doi: 10.1016/j.jcrs.2012.08.036 pmid: 23069271

Dubbelman M, Sicam VA, Van der Heijde GL. The shape of the anterior and posterior surface of the aging human cornea. Vision Res. 2006 Mar;46(6-7):993-1001. Epub 2005 Nov 2. PubMed PMID: 16266736.

Modis Ls, Langenbucher A, Seitz B. Evaluation of Normal Corneas Using the Scanning-Slit Topography/Pachymetry System. Cornea. 2004;23(7):689-94. doi: 10.1097/01.ico.0000126315.05519.0b

Dantas AM. Clínica Oftalmológica. Rio de Janeiro: Guanabara Koogan; 1980.

Ojeda JL, Ventosa JA, Piedra S. The three-dimensional microanatomy of the rabbit and human cornea. A chemical and mechanical microdissection-SEM approach. J Anat. 2001 Nov;199(Pt 5):567-76. pmid: 11760887

Paschoal MA. Manual de Oftalmologia. Rio de Janeiro: Cultura Médica. 2008.


Full Text: Free Full Text PDF

Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.