Analysis Of Visual Quality After Limbal Release And Incision Surgery For Correction Of Cataract Combined With Moderate To Low Degree Corneal Astigmatism

ObjectiveTo compare the effectiveness of corneal limbal release incisions(LRIs)with steep-axis clear corneal incisions(CCI)in the correction of corneal astigmatism and the effect on corneal higher-order aberrations in patients with cataracts combined with low to moderate degree corneal astigmatism.Methods47 patients(54 eyes)who had completed cataract ultrasound-emulsification combined with IOL implantation at our hospital from April 2022 to December 2022 and had combined preoperative corneal astigmatism of 1.0 D to 2.0 D were collected.Each group was divided into two subgroups according to the degree of corneal astigmatism,with subgroup 1 having preoperative corneal astigmatism of 1.0 to 1.5 D and subgroup 2 having preoperative corneal astigmatism of 1.5 to 2.0 D.Fourteen eyes in group A1 and 13 eyes in group A2 underwent LRIs to correct corneal astigmatism.All 13 eyes in group A1 and 13 eyes in group A2 underwent LRIs combined with cataract ultrasound emulsification,13 eyes in group B1 underwent SCCI in the steep axis and 14 eyes in group B2 underwent POCCI combined with cataract ultrasound emulsification in the steep axis.The postoperative follow-up was3 months,and the postoperative UCVA,BCVA,contrast sensitivity,residual corneal astigmatism,and corneal higher-order aberration changes were observed and compared between the two groups.Result1.The UCVA and BCVA of patients in both groups at 1 day,1 week,1 month and 3 months after surgery were significantly higher than those before surgery(F1=78.496,F=57.632;F2=58.76,F=71.104;P<0.001);the UCVA of the A2 group was better than that of the B2 group at all postoperative periods(P=0.014;P=0.005;P= 0.002;P=0.004);2.the corneal astigmatism values at 1 day,1 week,1 month,and 3 months postoperatively was significantly reduced in both groups compared to the preoperative period(F1= 211.827,F2= 130.283;P<0.001);corneal astigmatism in the A2 group was lower than that in the B2 group at all postoperative periods(P<0.001;P<0.001;P=0.004;P=0.003);3.no significant change in corneal higher-order aberrations in the 4-mm pupil diameter range at 3 months postoperatively compared with the preoperative period(P > 0.05);4.At 3 months postoperatively,the highest CS that could be resolved in the18 cpd operated eyes under bright vision glare and dark vision glare was better in the A2 group(0.74±0.28,0.70±0.31)than in the B2 group(0.48±0.27,0.46±0.28),with statistically significant differences(P=0.014;P=0.035).ConclusionThe data from this study shows that for cataract patients with preoperative moderate to low degree corneal astigmatism of 1.0-2.0D,the use of correction for corneal astigmatism using LRIs is more accurate and stable compared to CCI on a steep axis,and does not introduce new higher-order aberrations.