The Key to Phaco-Refractive Surgery: Does a Small Incision Make a Big Difference?

Purpose To study and compare the efficacy of 2.8 mm single clear corneal incision versus 2.8 mm paired clear corneal incision on pre-existing astigmatism in patients undergoing phacoemulsification cataract surgery. Methods A prospective randomized double-blinded interventional comparative study was conducted at a tertiary healthcare center. The patients undergoing unilateral cataract surgery were divided into two groups: group A, patients undergoing phacoemulsification through a 2.8 mm single clear corneal incision (CCI), and group B, patients undergoing phacoemulsification through 2.8 mm opposite clear corneal incisions (OCCIs). Postoperative assessment was done at one day, one week, three weeks, and three months to note uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), ophthalmic examination, corneal keratometry, and surgically induced astigmatism. Results A total of 130 eyes of 130 patients were included in our study. The change in corneal astigmatism was statistically significant (p = 0.04) in the paired OCCI group, while it was not statistically significant (p = 0.542) in the single CCI group at the end of three months. On comparing the change between the two groups, the paired OCCI group induced a greater degree of astigmatic change than the single CCI at three months, and it was statistically significant (p = 0.03). Conclusion There was a significant reduction in postoperative corneal astigmatism at three months with 2.8 mm paired OCCI, and the intergroup comparison was statistically significant. A 2.8 mm paired OCCI induces more surgical astigmatism at the end of three months than a 2.8 mm single clear corneal incision.