Shahzad Iftikhar, Zeba Ilyas Matin, Asif Kiani.
Outcome of phaco incision on steepest meridian in eyes with pre existing astigmatism.
Pak J Med Sci Jan ;24(2):227-30.

Objective: To determine keratometric outcome of a 5.5mm self sealing incision on the steepest meridian in eyes with preexisting astigmatism. Methodology: A prospective study was carried out on 35 eyes with preexisting, with or against the rule astigmatism of 1.5-3.0 D. Bimanual phaco was performed using the incisions of 1.5mm, each approximately 120 degrees apart. The IOL was implanted through a third self sealing limbal incision created on the steepest meridian, which was assessed preoperatively by keratometeric readings. Postoperative automated keratometery was recorded at 12 weeks. Results: The average reduction of pre-existing against and with the rule astigmatism was 1.15 (SD = 0.33) and 1.47 (SD = 0.32) respectively. Conclusions: It is possible to achieve negligible or low astigmatic outcomes in eyes with pre-existing with or against the rule astigmatism by predetermining the steepest meridian and placing a third incision of around 5.5mm on the respective meridian.

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