Corneal astigmatism induced by scleral small incision versus corneal tunnel incision in children after cataract surgery

Abstract

Background The amount of postoperative astigmatism is an important factor in the development of amblyopia in children. Early postoperative astigmatism is of concern since amblyopia treatment is usually initiated as soon as possible after cataract surgery, and precise optical correction of astigmatism is needed to maximize visual improvement. Small-incision cataract surgery is preferred by some pediatric ophthalmologists, as it reduces corneal scarring and this reduces the incidence of irregular astigmatism. Also, it is very useful in cases with micro cornea and cases with low endothelial count. However, it has many disadvantages such as increased risk of bleeding, slower visual recovery, hyphemia from scleral vessels, and postoperative surgically induced astigmatism. Aim To assess corneal astigmatism induced by scleral tunnel small incision versus corneal tunnel incision after cataract surgery in children. Patients and methods The study was a prospective study and included 30 eyes of 30 children with cataract from the outpatient clinic of the ophthalmology department of Tanta University in the period between December 2021 to July 2022. Results There was an insignificant difference between the small incision and corneal tunnel incision as regard K1 and K2 prereadings, after 2 weeks, after 6 weeks, and after 3 months of readings. Conclusion We think that both corneal tunnel and scleral tunnel are stigmatically neutral in pediatric cataract surgery.