Comparison Of Surgically Induced Astigmatism Between One Side Port And Two Side Ports With 2.8mm Corneal Incision In Phacoemulsification

Abstract

Objective: To compare the outcome of surgically induced astigmatism between one side port and two side ports with 2.8mm corneal incision in phacoemulsification.

Design:  Randomized Controlled Trial

Place and duration of Study: Department of Ophthalmology, Sahiwal Teaching Hospital, Sahiwal, and Study was carried out over a period of six months from 09-06-2024 to 09-12-2024.

Methodology: We conducted a randomized controlled trial at the Department of Ophthalmology, Sahiwal Teaching Hospital, Sahiwal, over six months from 09-06-2024 to 09-12-2024. Sixty patients scheduled for cataract surgery were randomly assigned to two groups of 30 eyes each. Group A underwent phacoemulsification with one side port, and Group B with two side ports. A single surgeon performed all surgeries using a uniform technique. Pre- and postoperative keratometric readings were recorded, and SIA was calculated using vector analysis.

Results: The two groups were comparable in baseline characteristics. Mean SIA was significantly lower in the one-side-port group (0.51 ± 0.01 D) than in the two-side-port group (1.51 ± 0.01 D; p = 0.0013). This pattern remained consistent across all demographic and clinical subgroups, suggesting that the number of side ports was the principal factor influencing postoperative astigmatic change.

Conclusion: Phacoemulsification performed with a single side port resulted in less surgically induced astigmatism than the two-side-port technique. Reducing the number of corneal entries may help improve refractive stability and uncorrected visual acuity. Surgeons may consider limiting side-port creation, particularly in cases where minimizing postoperative astigmatism is a priority.