Astigmatism after Cataract Alternative Phaco Surgery

Abstract

Purpose: The present authors studied astigmatism in alternative phaco cataract surgery at the University Hospital HKM of Cotonou. Keywords: Astigmatism; Cataract Surgery; Phacoalternative Patients and Methods: The study is a cross-sectional and retrospective one which covered a 7-year period from January 1st, 2010 to December 31st, 2016. It involved all patients who had cataract surgery without suturing during the study period. A total of 129 eyes from 129 patients were retained. Introduction Astigmatism is a variety of non-spherical ametropia, usually characterized by an absence of sphericity of the anterior surface of the cornea. This inequality of the corneal radii of curvature makes that the image of a point is not a point but a surface [1]. It can be congenital or acquired during surgery of the anterior segment. The removal of the opacified lens by a sclero-corneal tunnel without suture (phacoalternative) can cause astigmatism postoperatively. It leads the subject to a fuzzy or double perception of objects. Results: T129 eyes of 129 patients were selected from 203 patients operated for cataract without suture, a percentage of 51%. The mean age of the patients was 59 ± 15 years. 53.5% were male and 46.5% female, a sex ratio of 1.15%. In the preoperative period, 64.4% of patients had significant astigmatism. In the postoperative period, 31% of patients have significant astigmatism. The higher astigmatism increased progressively from 68.2% to 55% from postoperative day 15 to day 45. The mean of astigmatism decreased gradually from day 15 to day 45 (2.8 ± 1.6 D at 2.3 ± 1.4 D). 56.6% of the patients had indirect astigmatism during the preoperative period. Indirect astigmatism accounted for 69% of cases at postoperative day 45. The average axis varied around 85 and 100°. Indirect astigmatism accounted for 89% of cases at postoperative day 45. Conclusion: Corneal astigmatism remains a concern after cataract surgery, hence the need to improve the phacoalternative to reduce induce astigmatism.