World Journal of
Pharmaceutical and Life Sciences

A STUDY OF ASTIGMATISM CORRECTION BY VARIOUS METHODS IN PHACOEMULSIFICATION SURGERY

Dr. Jaishree Dwivedi*, Dr. Alka Gupta, Dr. Lokesh Kumar Singh, Dr. N. Gupta

ABSTRACT

Cataract surgery has evolved into a precise refractive procedure with the goal of achieving optimal postoperative visual outcomes. Residual astigmatism significantly affects uncorrected visual acuity (UCVA), making its correction during phacoemulsification an important determinant of patient satisfaction. Aim: To evaluate and compare the efficacy of various methods of astigmatism correction—clear corneal incision, limbal relaxing incision (LRI), and toric intraocular lens (IOL)—performed during phacoemulsification surgery. Materials and Methods: A prospective, non-randomized, comparative study was conducted on 60 patients with age-related cataract and pre-existing corneal astigmatism (<4D) at the Department of Ophthalmology, LLRM Medical College, Meerut. Patients were divided into three groups:
• Group 1: <1D astigmatism – clear corneal incision on the steep axis
• Group 2: 1–2D astigmatism – limbal relaxing incision using Nichamin nomogram
• Group 3: 2–4D astigmatism – toric IOL implantation.
Postoperative follow-up was done on day 1, week 1, week 4, and week 12. UCVA, keratometric readings, and surgically induced astigmatism were evaluated and analyzed statistically. Results: All three methods showed a statistically significant improvement in UCVA and reduction of astigmatism (p<0.05) at each postoperative interval. By week 12, 55% of Group 1, 70% of Group 2, and 75% of Group 3 achieved UCVA of 6/6. Mean residual astigmatism at week 12 was 0.05D, 0.03D, and 0.01D respectively, indicating excellent visual outcomes across all groups. Conclusion: All three modalities—clear corneal incision, LRI, and toric IOL—are safe, effective, and predictable for correcting astigmatism during phacoemulsification. Clear corneal incision is suitable for low astigmatism, LRI for moderate astigmatism, and toric IOL for higher degrees. LRI provides a cost-effective alternative to toric IOLs, while toric lenses offer superior precision and stability for significant astigmatic correction.

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