Minimizing Surgically Induced Astigmatism at the Time of Cataract Surgery Using a Square Posterior Limbal Incision

Purpose. To compare the surgically induced astigmatism from clear corneal and square posterior limbal incisions at the time of cataract surgery. Methods. Surgically induced astigmatism was calculated for a set of eyes after cataract surgery using a temporal 2.2 mm square posterior limbal incision. Results were compared to similar available data from surgeons using clear corneal incisions of similar size. Results. Preoperative corneal astigmatism averaged 1.0 D and was not significantly different between the incision types. Surgically induced astigmatism with the 2.2 mm posterior limbal incision averaged 0.25 ± 0.14 D, significantly lower in magnitude than the aggregate surgically induced astigmatism produced by the 2.2 mm clear corneal incision (0.68 ± 0.49 D). Conclusion. The 2.2 mm square posterior limbal incision induced significantly less, and significantly less variable, surgically induced astigmatism relative to a similar-sized clear corneal incision. This is likely to improve refractive outcomes, particularly important with regard to premium intraocular lenses.