COECSA, Journal, Ophthalmology
Surgical induced astigmatism and associated factors in manual small incision cataract surgeries done at the Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Diabetic Retinopathy
Prevalence
Clinical Profile
Southwestern Uganda

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How to Cite

Dr. Ruth Alemu Yami. (2024). Surgical induced astigmatism and associated factors in manual small incision cataract surgeries done at the Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. The Journal of Ophthalmology of Eastern, Central and Southern Africa, 15(01). Retrieved from https://joecsa.coecsa.org/index.php/joecsa/article/view/316

Abstract

Background: Cataract surgery is a popular ophthalmic procedure with a high success rate for restoring vision.
Its goal is to minimize astigmatism after surgery and achieve desired refractive outcomes. This study examines
Surgically Induced Astigmatism (SIA) at Saint Paul’s Hospital Millennium Medical College (SPHMMC), providing
valuable insights for developing practical cataract surgery guidelines.
Objective: The objective of the study was to determine the level of post-operation astigmatism and its associated
factors in manual small incision cataract surgery (MSICS) at Saint Paul’s Hospital Millennium Medical College,
Addis Ababa, Ethiopia.
Design: A prospective analytical study was conducted at SPHMMC, Addis Ababa, Ethiopia.
Setting: The study included all patients who underwent MSICS cataract surgery in the SPHMMC eye clinic during
the study period and agreed to participate.
Methods: The hospital-based prospective study analyzed MSICS patients at SPHMMC hospital in Ethiopia for
ten months (2019/2020), excluding those with previous intraocular surgery or complications. Using convenience
non-probability sampling, a structured questionnaire collected data on independent variables like age, sex, and
incision details. SPSS version 23 was used to analyze the data, focusing on the dependent variable, surgically
induced astigmatism. Descriptive and logistic regression analyses were performed to determine the association
between factors.
Results: A total of 240 subjects aged 40-85 years with a mean age of 63.1 (SD±9.89) years and pre-operative visual
acuity ranging from 6/60-LP were studied. Clinically significant surgically induced astigmatism ranged from 0
to 5.62D, with a mean SIA of 1.38D (SD±0.92D) and axis of 88.12 (SD±56.74). Multivariable logistic regression
showed significant associations between surgically induced astigmatism and tunnel size (P=0.000) and suture
presence (P=0.005).
Conclusion: Scleral tunnel size and wound sutures are critical factors associated with significant SIA. Whenever
it is necessary to put a suture at the end of the surgery, removing it at the third postoperative visit is always
important.
Recommendation: It is recommended to measure tunnel size with a caliper, especially during the beginning
periods of doing MSICS, and to minimize it.

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References

Nidhi J, Deepak C, Rejan KC, et al. Comparison of

surgically induced astigmatism in various incisions

in manual small incision cataract surgery. Int J

Ophthalmol, 2014; 7(6): 1001–1004.

Dr. Swapnil Bhalekar, BCSC, Clinical Optics, section

, 2011-2012;chapter 3, 114-116.

http://www.who.int/blindness/causes/priority/en/

index1.html (cited on June 5, 2018)

Adio AO, Aruotu N. Induced astigmatism after

cataract surgery - a retrospective analysis of cases

from the University of Port Harcourt Teaching

Hospital, Nigeria. S Afr Optom. 2011; 70(2) 75-80.

Kağnici DB, Kocatürk T, Çakmak H, et al. Surgically

induced corneal astigmatism following cataract

surgery. Open J Ophthalmol. 2015; 5:47-53.

https://www.researchgate.net/publication/338392106_

SIA_Calc_v_21 (cited on April 2019)

World Health Organization. Global data on visual

impairments. 2010.https://www.who.int/blindness/

publications/globaldata/en/ (Cited on April 2,2020)

Spierer A, Bar-Sela SM. Changes in astigmatism

after congenital cataract surgery and intraocular lens

implantation: a comparative study. Arch Ophthalmol.

; 122(5):695-697.

Bhattacharyya B. Textbook of Visual Science and

Clinical Optometry, 296.

World Health Organization. Informal consultation on

analysis of blindness prevention outcomes. Geneva,

Switzerland: WHO; 1988. PBL/98.68

Nag D, Hennig A, Foster A, et al. Postoperative

astigmatism after intracapsular cataract surgery:

results of a randomized controlled trial in Nepal.

Indian J Ophthalmol. 2001; 49(1):31-35.

Curragh DS, Hassett P. Prevalence of corneal

astigmatism in an NHS cataract surgery practice in

Northern Ireland. Ulster Med J. 2017; 86(1):25-27

Jonatha H, Stark WJ, John D,Daniel G, Pratzer

GK, et al. Natural history of corneal astigmatism

after cataract surgery. J Cataract Refrac Surg. 1991;

(3):313-318.

Baksi R. Surgically induced astigmatism in tunnel

construction in small incision cataract surgery.

JMSCR. 2020; 08(01):184-189.

Sekharreddy MR, Sugantharaj V, Hegde SP. Surgically

induced astigmatism in manual small-incision cataract

surgery: A comparative study between superotemporal

and temporal scleral incisions. TNAO Jophthal Scie

Res. 2019; 57:105-108.

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