COMPARATIVE ANALYSIS OF INCISION DESIGNS AND THEIR IMPACT ON SURGICALLY INDUCED ASTIGMATISM AND VISUAL OUTCOMES IN MANUAL SMALL INCISION CATARACT SURGERY

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Background: Surgically induced astigmatism (SIA) is a critical factor influencing visual quality following manual small incision cataract surgery (MSICS). The architecture of the scleral tunnel may significantly influence postoperative refractive stability and visual recovery. Methods: This comparative study included 480 eyes undergoing MSICS, equally assigned to four incision groups: Chevron, Back-cut Straight, Frown, and Straight (n = 120 each). Baseline ocular characteristics were comparable. Uncorrected and best-corrected visual acuity (UDVA, BCVA) and SIA (vector analysis) were assessed at postoperative Day 1, Week 1, Week 4, and Week 6. Results: By the sixth week, the Chevron group achieved the most favorable outcomes, recording a mean UDVA of 0.18 ± 0.13 logMAR and BCVA of 0.08 ± 0.07 logMAR. Back-cut Straight incisions produced intermediate results, followed by Frown, while Straight incisions yielded the least improvement. Mean SIA was lowest in the Chevron group (0.48 ± 0.36 D) and highest in the Straight group (1.12 ± 0.62 D) (p < 0.001). Residual cylinder ≤0.50 D was highest in Chevron (70.0%) and lowest in Straight incision cases (31.7%). Conclusion: Chevron incisions demonstrated the greatest refractive predictability and visual recovery in MSICS. Back cut Straight incisions may serve as a practical alternative for achieving controlled astigmatism while maintaining technical simplicity. Tailoring incision design can enhance visual outcomes without additional instrumentation.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.