Astigmatic stabilization of 3.0 mm temporal clear corneal cataract incisions

Purpose: To determine the time needed for corneal shape changes to stabilize after a laterally oriented, 3.0 mm, unsutured, single-hinge clear corneal tunnel cataract incision combined with implantation of a foldable acrylic 5.5 mm intraocular lens. Setting: Advanced Vision Care, West Hills, California. Methods: The study comprised 45 patients who had a similar phacoemulsification technique and lens implantation through an unenlarged 3.0 x 2.5 mm self-sealing temporal clear corneal tunnel incision. Changes in corneal curvature were determined by computerized videokeratography (corneal topography) prior to surgery and at 1, 2, and 6 weeks after surgery. Simulated keratometry was ascertained from topography and analyzed with the Lens-Stat software program. Results: Preoperative corneal cylinder, cylinder axis, and central corneal curvature did not change markedly after surgery. By vector analysis, approximately 0.50 diopter (D) of induced cylinder was noted, whereas less than 0.25 D of cylinder change was observed in the surgical meridian. Although statistically similar, there were slight differences between the data at 1 and 2 weeks postoperatively. However, the 2 and 6 week data were indistinguishable, indicating that the incision method used in the study was fully stable within 2 weeks of surgery. Conclusions The surgical method resulted in stable corneal curvature by 2 weeks after surgery at which time the patient is ready for final spectacle prescription and can be discharged from acute postoperative ophthalmologic care in the absence of complicating factors. The shortened recovery time is beneficial for the patient and has significant potential effects on the global costs of cataract rehabilitation and the reimbursement schemes for postoperative management.