Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Lamellar Keratotomy to Correct Astigmatism in Cataract Surgery

Wirbelauer C., Späth U., Böhm T., Häberle H., Pham D. T.
Dept. of Ophthalmology Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin

Purpose: For the correction of astigmatism in cataract surgery several incisional procedures have been developed. In this study a modification of lamellar keratotomy was evaluated to correct astigmatism in cataract surgery.
Method: Prospectively 21 patients with a preoperative astigmatism of greater than 1.5 diopters (D) were studied. All patients were treated with a corneal incision and modified lamellar keratotomy in the steep meridian with an incision width of 6 mm and a radial length of 1.5 mm. Phacoemulsification and IOL implantation were performed through a 3.2 mm incision. After 4 weeks the mean astigmatism, the mean corneal power changes and the mean surgically-induced astigmatism derived from vector analysis in the central 3 mm optical zone were determined.
Results: The modified lamellar technique was also combined with a temporal or oblique approach. The mean astigmatism decreased from 2.74±0,81 D preoperatively to 1.52±1,11 D after 4 weeks (P=0,004). There were no significant changes (P=0,653) of the mean corneal power. The mean surgically-induced astigmatism was 2.70±1.38 D. In corneal topography most patients revealed a characteristic threefold pattern of the peripheral cornea.
Conclusions: The presented modified lamellar keratotomy effectively reduced high preoperative astigmatism in cataract surgery. The surgical approach can be combined

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