Astigmatism outcomes of scleral tunnel and clear corneal incisions for congenital cataract surgery

Abstract

Purpose: To evaluate astigmatism outcomes after congenital cataract surgery with intraocular lens implantation using clear corneal or scleral tunnel incisions. Methods: We retrospectively reviewed the medical records of 46 children (67 eyes), aged 2 months to 12 years, who had undergone nontraumatic cataract extraction and intraocular lens implantation between 1996 and 2001, using a scleral tunnel incision (group 1), or a clear corneal incision (group 2). Refractive astigmatism was measured at 1 week, 3 months, and 5 months after surgery. Paired t-test was used to compare those variables, and Spearman's correlation was used to determine their relation to patient's age. Results: Mean±SD astigmatism at 1 week postoperatively was 3.1±2.8 Diopter (D) and 2.1±1.7D in groups 1 and 2, respectively. It significantly reduced to 1.1±1.2D and 0.9±1.0D, respectively, in the two groups at 5 months postoperatively (P<0.007). In both groups patients' age was significantly correlated with 1-week postoperative astigmatism (group 1: r=0.64; P=0.001; group 2: r=-0.58; P=0.003), and with the change in cylinder magnitude between 1 week and 3 months postoperatively (group 1: r=-0.67; P=0.001; group 2: r=0.50; P=0.013). Conclusion: Children who underwent congenital cataract surgery using clear corneal or scleral tunnel incisions showed high postoperative astigmatism at 1 week postoperatively, which spontaneously reduced during 5 months follow-up. Therefore, suture removal is not necessary in those cases.