To compare surgically induced astigmatism in SICS using two different incision sites – “superior vs. temporal”

Cataract is one of the most important curable causes of blindness in India. Nowadays although the ‘cataract surgery of choice' is phacoemulsification; manual small incision cataract surgery (SICS) has emerged as an alternative technique owing to its being cost-effective and having all advantages of a self-sealing sutureless incision but with the disadvantage of having higher postoperative astigmatism. The aim of our study was to compare the surgical outcome using two different incision sites – “superior and temporal” in terms of surgically induced astigmatism. After taking Informed consent all the patients were divided randomly into two groups. Group S received Superior incision and group T Temporal incision. All surgeries were performed under peribulbar anesthesia using an incision size of 6 – 6.5 mm. The incision architecture was kept same in both the groups. Postopratively patients were examined on days 1, 7, 30, 45 and 90. Keratometry with Uncorrected and Best corrected visual acuity was recorded on subsequent visits. The surgically induced astigmatism (SIA) was calculated by Vector method. When SIA was compared between the two groups, both in magnitude as well as axis, the change was found to be lower in temporal group as compared to superior group S. It was statistically significant (p=0.004). We therefore conclude that though both the groups had good postoperative visual acuity patients of group S had more postoperative and surgically induced astigmatism and therefore greater dependence on spectacles as compared to group T and this was found to be statistically significant.