On the Venn Diagram of my research interests, this recent publication sits right in the middle of posterior corneal astigmatism and surgically induced astigmatism in cataract surgery!
My recent discussion in CRS Today about surgically induced astigmatism created some great discussion about whether to operate on the steep axis or temporally and this paper adds to that. We found that with a 1.8mm clear corneal incision made temporally that there was minimal posterior SIA and that it could not be predicted by biometric measurements pre-op. Even more interestingly, it’s magnitude was not affected by location of the steep meridian.
The tl:dr summary is, we can’t adjust our plans for posterior corneal SIA and it appears with a tiny incision made temporally that we don’t need to. Remember, to minimize SIA:
1) Small incisions
2) Temporal incisions
3) Incisions as far from the central cornea as possible
It’s really that simple.