Minimal astigmatism after sutureless planned extracapsular cataract extraction

Purpose: To evaluate astigmatism after mini-nuc extracapsular cataract extraction (ECCE) in which a chevron incision is enlarged to 6.0 to 7.0 mm for easier nucleus removal and to compare the results with those using a 5.0 mm incision. Setting: Department of Ophthalmology, The Edith Wolfson Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Holon, Israel. Methods: Thirty eyes-of 29 patients were enrolled in this study. Keratometry was performed preoperatively and 3 to 9 months postoperatively. The incision length was 6.0 mm in 6 eyes, 6.5 mm in 10 eyes, and 7.0 mm in 14 eyes that had mature cataract. Results: The mean induce astigmatism calculated by simple subtraction was 0.12 diopter (D) ± 0.51 (SD), 0.16 ± 0.98 D, and 0.67 ± 0.91 D, for the 6.0 mm, 6.5-mm, and 7.0 mm incision, respectively. By vector analysis, the mean induced astigmatism was 0.60 ± 0.30 D, 0.75 0.67 D, and 1.36 ± 0.77 D, respectively. Results by both methods showed no significant difference between previously reported 5.0 mm incision and the 6.0 mm and 6.5 mm incisions. The 7.0 mm group had statistically significantly greater induced astigmatism than the 5.0 mm group (P =. 01, simple subtraction; P =.002, vector analysis). Conclusions: Enlarging the size of the chevron incision up to 7.0 mm resulted in a small increase in induced astigmatism. The enlarged incision simplified the operative technique.