A Comparison Study On The Cataract Surgery By Three Different Kinds Of Incisions With Corneal Topography

Purpose: Cataract is the major eye disease which can cause to the blind around the world. The definite and effective treatment is extracting the turbid lens through surgery. Recovering vision is important of cataract surgery, but, with time gone, the significance of cataract surgery is not only to make patients see, but also to improve patients' uncorrected visual acuity (UCVA), correct astigmatism. Present cataract surgery has changed into the refractive surgery. While the postoperative corneal astigmatism is one of the most important factor which influences the early- stage post operative UCVAThe cataract surgery incision can induce different postoperative corneal astigmatism in length, location, shape, the kind of suture material, the tightness degree of the suture and so on. The purpose of this clinic study adopting computer assisted corneal topography system, is to compare the changes in corneal topography, value and axis of corneal astigmatism and UCVA after cataract surgery through three different kinds of incisions to evaluate their clinical results and give impersonality data for clinic.Methods The 90 cataract patients (100 eyes) were divided into three groups. GroupⅠ:1.5～2.2mm bimanualmicrophacoemulsification .GroupⅡ: 3.2～3.5mm seleral tunnel phacoemulsification; groupⅢ: 5.5～7.0mm against eyebrow seleral tunnel incision nonphacoemulsificative extracapsular cataract extraction (SICS). Measurement of corneal topography, value and axis of corneal astigmatism and UCVA were obtained preoperatively, 1 day, 1 week, 1 month and 3 months postoperatively. Comparing with UCVA, the value and axis of corneal astigmatism and the corneal topography changes in different time.Results: All postoperative UCVA are better than pre- operative UCVA(P<0.01).At 1 day,1 week,1 month and 3 months, the post operative UCVA of the groupsⅠandⅡare better than groupⅢ(P<0.01) .Corneal topography in groupⅠand groupⅡshowed upper wound-related flattening in longitude and steepening in horizontal 2 opposite radial sectors in following time postoperatively, the changes of axis of corneal astigmatism preoperatively and post operatively in groupⅠshowed no significant difference ,while in groupⅡshowed significant difference(P<0.01),the number of against regular astigmatism (ARA) increased ; groupⅢshowed early steepening in longitude and late the number of steepening in horizon increased, at postoperative 1 week, the number of with regular astigmatism (WRA) increased, at postoperative 1 and 3 months, the number of WRA decreased and ARA increased(P<0.01).Conclusions: Comparing with 1.5～2.2mm bimannualmicrophacoemulsification and 3.2～3.5mm selerocorneal tunnel phacoemulsification and eyebrow scleral tunnel against 5.5～7.0mm eyebrow scleral tunnel incision nonphacoemulsification extracapsular cataract extraction can obtain a quicker and better rehabilitation of UCVA, a minor and steady corneal astigmatism in the early postoperation periond.