[Minimizing astigmatism by controlled localization of cataract approach with the no stitch technique. A prospective study]

Abstract

Background: The no-stitch-technique with deliberate localisation of the cataract incision is a method to reduce the postoperative astigmatism. This prompted us to investigate the postoperative astigmatism with varying incision localisation; our aim is to achieve a postoperative astigmatism < or = 1.0 D.

Patients and method: In this study we controlled 319 eyes of 316 cataract patients. We took into consideration the preoperative astigmatism and operated in the 12 o'clock or lateral position. The astigmatism was measured by an ophthalmometer preoperatively, on the first day, after 3-5 months and 8-12 months after surgery.

Results: A preoperative astigmatism of up to < or = 1.0 D was present in 82.4% of eyes. On the first day after surgery an astigmatism of < or = 1.0 D was present in 89.3% of eyes. After 3-5 months postoperatively astigmatism was < or = 1.0 D in 97.2% and in 98.8% after 8-12 months postoperatively. 15.7% of patients showed a preoperative astigmatism between 1 and 2 D, but only 1.2% after 8-12 months. There was no astigmatism > 2.0 D after 3-5 months and 8-12 months (preoperative 2%).

Conclusions: The no-stitch-technique permits to control the postoperative astigmatism with deliberate localisation of the cataract incision. Postoperative astigmatism appeared to be stable. We therefore recommend for preoperative "ATR (Against the rule)-Astigmatism" (> or = 1.0 D) operation in lateral position and for preoperative "WTR (With the rule)-Astigmatism" operation in the 12 o'clock position.