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   Table of Contents      
LETTER TO THE EDITOR
Year : 2014  |  Volume : 62  |  Issue : 6  |  Page : 753

Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery


Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea

Date of Web Publication8-Jul-2014

Correspondence Address:
Prof. Dong Heun Nam
Department of Ophthalmology, Gachon University Gil Hospital, #1198, Kuwol-dong, Namdong-ku, Incheon - 405 760
Korea
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.136308

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How to cite this article:
Yoon JH, Kim KH, Lee JY, Nam DH. Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery. Indian J Ophthalmol 2014;62:753

How to cite this URL:
Yoon JH, Kim KH, Lee JY, Nam DH. Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery. Indian J Ophthalmol [serial online] 2014 [cited 2019 Aug 23];62:753. Available from: http://www.ijo.in/text.asp?2014/62/6/753/136308

Dear Editor,

We thank Yoon JH et al. [1] for their interest in our article "Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery". [1] They raised concerns about an endophthalmitis and an axis shift following bilateral cataract surgery using temporal and nasal incisions. We appreciate their comments.

With regard to the endophthalmitis, both temporal and nasal incisions may be risky because of clear corneal cataract surgery. A population-based study is needed to evaluate the rate and risk factors of endophthalmitis following the nasal clear corneal cataract surgery, while the nasal cataract surgery has not been widely used. However, we do not think that the nasal incisions are more risky for endophthalmitis than other incisions (temporal or superolateral). We have not experienced any endophthalmitis or wound dehiscence following the nasal incision cataract surgery since 2006. More recently in clear corneal cataract surgery, furthermore, the surgical skills have been advanced and the incidence of endophthalmitis has decreased. [2],[3]

With regard to the axis shift, we evaluated not only the corneal astigmatism but also the axis. The change of both the corneal astigmatism and the axis were calculated by vector analysis using the Holladay-Cravy-Koch formula. [4] Although the corneal axis symmetry after bilateral cataract surgery was not evaluated in our paper, the axis shift in the nasal incisions was similar to that in the temporal incisions. Further study about the corneal axis symmetry is necessary.

İn addition, the superolateral incision may be a good option for superior approach, clear corneal cataract surgery. Nonetheless, the superolateral incisions induced greater refractive changes than the horizontal incisions. [5]

 
  References Top

1.
Yoon JH, Kim KH, Lee JY, Nam DH. Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery. Indian J Ophthalmol 2013;61:645-8.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Lundström M, Wejde G, Stenevi U, Thorburn W, Montan P. Endophthalmitis after cataract surgery: A nationwide prospective study evaluating incidence in relation to incision type and location. Ophthalmology 2007;114:866-70.  Back to cited text no. 2
    
3.
Friling E, Lundström M, Stenevi U, Montan P. Six-year incidence of endophthalmitis after cataract surgery: Swedish national study. J Cataract Refract Surg 2013;39:15-21.  Back to cited text no. 3
    
4.
Holladay JT, Cravy TV, Koch DD. Calculating the surgically induced refractive change following ocular surgery. J Cataract Refract Surg 1992;18:429-43.  Back to cited text no. 4
    
5.
Rainer G, Menapace R, Vass C, Annen D, Findl O, Schmetterer K. Corneal shape changes after temporal and superolateral 3.0 mm clear corneal incisions. J Cataract Refract Surg 1999;25:1121-6.  Back to cited text no. 5
    




 

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