Corneal aberrations before and after corneal and corneoscleral small incision cataract surgery

Background: The corneal as well as the corneoscleral incisions are considered to be standard in cataract surgery. However, both incision techniques have their advantages and disadvantages. We investigated whether the way of performing the incisions has different effects on the corneal wavefront, especially on higher-order aberrations. Methods: Each of 26 patients (6 men, 20 women), aged between 62 and 85 years (average 74.9 +/- 6.69 years), received a standard phako-emulsification by performing a corneal incision on the right eye (group 1) and a corneoscleral incision on the left eye (group 2). The corneal surface was preoperatively investigated by using the corneal wavefront instrument Optikon Keratron Scout, (Schwind Company, Germany). After 6 to 8 weeks the same parameters were measured again. Results: The statistical analysis of the pre- and postoperative data within the same group indicated significant differences (p < 0.05) in group 1 for Z (3 +/- 3) = Trefoil and in group 2 for Z (2 +/- 2) = Astigmatism. On comparing the postoperative data of the corneal incision with those of the corneoscleral incision, there was only a significant difference (p < 0.05) for Z (3 +/- 3) = Trefoil. Conclusion: In accordance with the induced higher-order aberrations both surgical techniques can be considered as being equivalent.