DR. PAVITHRA. V,DR. DIVYA N,DR. V. PANIMALAR. A. VEERAMANI,DR. ANGELIN FIONA J
DOI: https://doi.org/Introduction: To compare the Surgically Induced Astigmatism (SIA) following Chevron, Straight, and Frown incisions in Manual Small-Incision Cataract Surgery (MSICS) and to evaluate their impact on postoperative astigmatism correction, visual acuity, and wound healing.
Material and Methods: A prospective, hospital-based study was conducted at the Department of Ophthalmology, Saveetha Medical College, Chennai, with 45 patients (15 per group) undergoing MSICS with Chevron, Straight, or Frown incisions. Patients were assessed at Day 1, Week 1, and Week 6 for SIA (measured using the SIA Calculator v2.1), Uncorrected Visual Acuity (UCVA), Best Corrected Visual Acuity (BCVA), wound integrity, and inflammation. Repeated Measures ANOVA and One-way ANOVA were used to analyze differences in SIA over time, and correlations were assessed between incision type, astigmatic changes, and wound healing parameters.
Results: The Chevron incision demonstrated the lowest residual SIA (0.255 ± 0.090D at Week 6) and the best wound integrity (2.666 ± 0.617), while the Frown incision exhibited favorable long-term astigmatic stability (0.242 ± 0.112D at Week 6). The Straight incision induced the highest SIA (0.798 ± 0.255D at Day 1, 0.462 ± 0.16D at Week 6), delaying astigmatic stabilization. UCVA and BCVA improved significantly in all groups, with the Chevron group achieving the best final BCVA (0.35 ± 0.141 at Week 6). ANOVA results showed significant differences in SIA between incision types at all time points (p < 0.05), confirming that incision type significantly influences postoperative astigmatism.
Conclusion: Chevron incisions are the most effective for reducing post-operative astigmatism and ensuring superior wound stability, while Frown incisions provide good long-term stability. Straight incisions result in higher residual astigmatism and require longer stabilization periods. The choice of incision should be tailored based on patient corneal biomechanics to optimize post-operative visual outcomes. Further research with larger sample sizes and extended follow-ups is recommended.
