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Purpose <p>To compare the effects of single clear corneal incision (CCI) and opposite clear corneal incision (OCCI) techniques on corneal and total astigmatism in patients undergoing phacoemulsification cataract surgery.</p> Methods <p>This retrospective comparative study included 285 eyes of 285 patients with preoperative total astigmatism of 0.75–3.0 diopters and corneal astigmatism of 0.50–2.0 diopters. Patients were divided into two groups: OCCI (141 eyes) and CCI (144 eyes). All surgeries were performed by the same surgeon using a standardized phacoemulsification technique with 2.4-mm clear corneal incisions placed on the steep meridian. In the OCCI group, a second identical incision was created 180° opposite the primary incision. Corneal astigmatism, total astigmatism, spherical equivalent, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and intraocular pressure were evaluated preoperatively and during a minimum 12-month follow-up.</p> Results <p>Preoperative demographic and ocular characteristics were comparable between groups (all <i>p</i> &gt; 0.05). Postoperatively, corneal astigmatism was significantly lower in the OCCI group compared with the CCI group (− 0.71 ± 0.48 D vs. −1.01 ± 0.56 D; <i>p</i> = 0.001). Total astigmatism was also significantly reduced in the OCCI group (− 1.19 ± 1.20 D vs. −1.51 ± 0.71 D; <i>p</i> = 0.004). Spherical equivalent and intraocular pressure did not differ significantly between groups. BCVA outcomes were comparable at all follow-up visits (<i>p</i> &gt; 0.05). However, UCVA was significantly better in the OCCI group at 3 months (<i>p</i> = 0.047) and 12 months (<i>p</i> = 0.031).</p> Conclusions <p>Opposite clear corneal incisions provide a stronger astigmatic corrective effect than single clear corneal incisions and result in superior uncorrected visual acuity at mid- and long-term follow-up. OCCI represents a simple, safe, and effective technique for correcting mild to moderate astigmatism during routine cataract surgery.</p>

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Comparison of the effects of single and opposite incision techniques on with-the-rule astigmatism in cataract surgery

  • 期刊论文

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  • 发表日期：

    2026年5月5日

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  • Emine Seker Un,
  • Tunahan Akyol,
  • Osman Parca,
  • Sevket Oguz Belli

摘要

Purpose

To compare the effects of single clear corneal incision (CCI) and opposite clear corneal incision (OCCI) techniques on corneal and total astigmatism in patients undergoing phacoemulsification cataract surgery.

Methods

This retrospective comparative study included 285 eyes of 285 patients with preoperative total astigmatism of 0.75–3.0 diopters and corneal astigmatism of 0.50–2.0 diopters. Patients were divided into two groups: OCCI (141 eyes) and CCI (144 eyes). All surgeries were performed by the same surgeon using a standardized phacoemulsification technique with 2.4-mm clear corneal incisions placed on the steep meridian. In the OCCI group, a second identical incision was created 180° opposite the primary incision. Corneal astigmatism, total astigmatism, spherical equivalent, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and intraocular pressure were evaluated preoperatively and during a minimum 12-month follow-up.

Results

Preoperative demographic and ocular characteristics were comparable between groups (all p > 0.05). Postoperatively, corneal astigmatism was significantly lower in the OCCI group compared with the CCI group (− 0.71 ± 0.48 D vs. −1.01 ± 0.56 D; p = 0.001). Total astigmatism was also significantly reduced in the OCCI group (− 1.19 ± 1.20 D vs. −1.51 ± 0.71 D; p = 0.004). Spherical equivalent and intraocular pressure did not differ significantly between groups. BCVA outcomes were comparable at all follow-up visits (p > 0.05). However, UCVA was significantly better in the OCCI group at 3 months (p = 0.047) and 12 months (p = 0.031).

Conclusions

Opposite clear corneal incisions provide a stronger astigmatic corrective effect than single clear corneal incisions and result in superior uncorrected visual acuity at mid- and long-term follow-up. OCCI represents a simple, safe, and effective technique for correcting mild to moderate astigmatism during routine cataract surgery.