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Comparing the astigmatic outcome after paediatric cataract surgery with different incisions
  1. Amit Gupta1,
  2. Muralidhar Ramappa2,
  3. Ramesh Kekunnaya1,
  4. Pravin K Vaddavalli2,
  5. Debajit Ray1,
  6. Sunita Chaurasia2,
  7. Harsha L Rao3,
  8. Chandra Sekar Garudadri3
  1. 1Jasti V Ramanamma Children's Eye Care Centre, Pediatric Ophthalmology Services, LV Prasad Eye Institute, Hyderabad, India
  2. 2Cornea and Anterior Segment Services, LV Prasad Eye Institute, Hyderabad, India
  3. 3Center for Clinical Epidemiology and Biostatistics, LV Prasad Eye Institute, Hyderabad, India
  1. Correspondence to Dr Muralidhar Ramappa, Paediatric Cornea and Anterior Segment Services, Kallam Anji Reddy Campus, LV Prasad Eye Institute, LV Prasad Marg, Banjara Hills, Hyderabad 500034, India; muralidhar{at}; dr.muralidhar{at}


Aims To compare astigmatism with clear corneal incision versus scleral tunnel incision following paediatric cataract surgery with primary intraocular lens implantation.

Methods Retrospective, comparative case series of 218 eyes of 138 children <12 years of age undergoing cataract extraction with intraocular lens implantation. The study cohorts were grouped into two categories based on incision location: group 1 comprising 108 eyes from 65 children with scleral incision; group 2 comprising 110 eyes from 73 children with clear corneal incision. Cycloplegic refraction was performed at 1, 3 and 6 months postoperatively.

Results The mean age in group 1 was 61±39 months and in group 2, 51±41 months. The mean postoperative astigmatism in group 1 was 1.28±0.97 D, 1.42±1.00 D and 1.38±0.98 D at 1, 3 and 6 months respectively. The change in astigmatism between 1 and 6 months was non-significant (p=0.26). The mean astigmatism in group 2 was 1.34±1.20 D, 1.13±0.88 D and 1.03±0.89 D at 1, 3 and 6 months respectively. Astigmatism in group 2 decreased significantly with time (p<0.001). The amount of astigmatism was comparable between the two groups at 1 month postsurgery (p=0.90), while it was significantly lower in the corneal incision group at 3 (p=0.03) and 6 months (p=0.01).

Conclusions Postoperative astigmatism after paediatric cataract surgery by clear corneal incision was lower compared with scleral incision. However, the difference was small and clinically insignificant.

  • Paediatric cataract surgery
  • astigmatism
  • Intra ocular lens
  • clear corneal incision,scleral tunnel
  • Lens and zonules

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  • Funding This study was funded by the Hyderabad Eye Research Foundation, India.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Ethics Committee of L V Prasad Eye Institute.

  • Provenance and peer review Not commissioned; externally peer reviewed.