A COMPARATIVE STUDY OF SURGICALLY INDUCED ASTIGMATISM IN SUPERIOR AND TEMPORAL SCLERAL INCISION IN MANUAL SMALL INCISION CATARACT SURGERY

Aim: To evaluate the amount and type of surgically induced astigmatism in superior and temporal scleral incision in Manual Small Incision Cataract Surgery (MSICS). Material and Methods: A prospective randomized comparative study was carried out in Upgraded Department of Ophthalmology, DMCH, Laheriasarai, Bihar. Total 100 cases of senile or pre-senile cataract included in this study from July 2019 to December 2019. All the patients underwent MSICS under peribulbar anaesthesia. The patients with very hard cataract were excluded so as to keep the incision size uniformity (6- 6.5mm). 50 cases received superior scleral incision and 50 cases received temporal scleral incision. Post operative astigmatism was studied in both groups using Bausch & Lomb Keratometer on 1st day, 7th day, 6th week and 3rd month. Results: After 3 months of surgery, out of 50 patients in superior scleral incision group 74% patients had ATR astigmatism and 16% patients had WTR astigmatism whereas in temporal scleral incision group 56 % of the patients had WTR astigmatism and 36 % had ATR astigmatism. The mean surgically induced astigmatism (SIA) in temporal incision group was signicantly less than the superior incision group after 3 months postoperatively (t=2.33, p<0.05). Conclusion: This study reveals that temporal approach MSICS produces less postoperative astigmatism and has manifold advantages over superior incision MSICS with excellent visual outcome.