Corneal coma and trefoil changes associated with incision location in cataract surgery

PURPOSE:To investigate changes in corneal higher-order aberrations (HOAs) associated with the incision location in cataract surgery. SETTING:Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. DESIGN:Observational case series. METHODS:Eyes were divided into 3 groups according to the different axes of incision location: superior, temporal, and nasal. Preoperative and 1-month postoperative corneal coma, trefoil, and spherical aberrations were compared. RESULTS:The study evaluated 119 eyes that had uneventful cataract surgery with a 2.2 mm limbal incision. The superior incision group showed significant changes in the vertical coma (amount of change: -0.119 μm ± 0.153 [SD]; P < .001) and vertical trefoil (amount of change: 0.185 ± 0.260 μm, P = .001). The nasal incision group showed a significant change in oblique trefoil (amount of change: 0.176 ± 0.207 μm; P < .001). The temporal incision group did not show significant changes in HOAs. CONCLUSION:The superior incision in 2.2 mm phacoemulsification cataract surgery caused a change in the corneal vertical coma in a negative direction. Corneal trefoil changes were dependent on the incision location. FINANCIAL DISCLOSURE:No author has a financial or proprietary interest in any material or method mentioned.