Astigmatism outcomes of scleral tunnel and clear corneal incisions for congenital cataract surgery

Purpose To evaluate astigmatism outcomes after congenital cataract surgery with intraocular lens implantation using clear corneal or scleral tunnel incisions. Methods We retrospectively reviewed the medical records of 46 children (67 eyes), aged 2 months to 12 years, who had undergone nontraumatic cataract extraction and intraocular lens implantation between 1996 and 2001, using a scleral tunnel incision (group 1), or a clear corneal incision (group 2). Refractive astigmatism was measured at 1 week, 3 months, and 5 months after surgery. Paired t-test was used to compare those variables, and Spearman's correlation was used to determine their relation to patient's age. Results Mean +/- SD astigmatism at 1 week postoperatively was 3.1 +/- 2.8 Diopter (D) and 2.1 +/- 1.7 D in groups 1 and 2, respectively. It significantly reduced to 1.1 +/- 1.2 D and 0.9 +/- 1.0 D, respectively, in the two groups at 5 months postoperatively (P < 0.007). In both groups patients' age was significantly correlated with 1-week postoperative astigmatism (group 1: r = 0.64; P = 0.001; group 2: r = -0.58; P = 0.003), and with the change in cylinder magnitude between 1 week and 3 months postoperatively (group 1: r = -0.67; P = 0.001; group 2: r = 0.50; P = 0.013). Conclusion Children who underwent congenital cataract surgery using clear corneal or scleral tunnel incisions showed high postoperative astigmatism at 1 week postoperatively, which spontaneously reduced during 5 months follow-up. Therefore, suture removal is not necessary in those cases.