Changes in total, anterior, and posterior corneal surface higher-order aberrations after 1.8 mm incision and 2.8 mm incision cataract surgery

Purpose: To evaluate changes in corneal higher-order aberrations (HOAs) on the anterior and posterior corneal surfaces after 1.8 mm microincision cataract surgery (MICS) and 2.8 mm small-incision cataract surgery (SICS). Setting: Eye Department, First Affiliated Hospital, School of Medicine, Zhejiang University, China. Design: Prospective case series. Methods: Right eyes of patients had MICS or SICS. The preoperative and 1-week and 3-month postoperative distance visual acuity (CDVA) and dry eye-related indices were determined. The corneal total HOAs and Zernike coefficients (3rd and 4th order) over 4.0 and 6.0 mm zones, corneal volume, central corneal thickness (CCT), and anterior and posterior corneal astigmatism were measured using a Pentacam HR analyzer. Results: The MICS group comprised 126 eyes and the SICS group 70 eyes. The MICS and SICS groups had similar postoperative CDVA; however, the MICS group had quicker recovery of CCT, corneal volume, and corneal astigmatism. Significantly increased anterior corneal total HOAs were observed in the SICS group over a 6.0 mm zone (P < .001). Both groups showed significantly increased posterior corneal total HOAs over both zones (P < .001). Similar changing patterns in individual Zernike terms were observed. The MICS group had quicker recovery of posterior corneal surface coma and trefoil than the SICS group, especially over the 6.0 mm zone. Changes in posterior corneal surface total HOAs were correlated with corneal volume changes (P < .01). Conclusions: The data suggest quicker corneal recovery and less change in total and anterior corneal surface corneal HOAs after MICS. Changes in posterior corneal surface HOAs were more pronounced in both surgical groups.