AIM:To investigate the effect of different corneal incisions on corneal astigmatism and visual acuity in patients treated by cataract surgeries and to improve the visual quality after cataract surgeries.

METHODS:Totally 96 patients with cataract who were going to take phacoemulsification and intracular lens(IOL)implantation were selected.They were randomly divided into group A and group B, 48 patients(48 eyes)in each group and both were comparability. Patients in group A were treated with corneal incision on the temporal side if the right eye was the affected one, or on the nasal side if the left eye was affected. Patients in group B were treated with axial corneal incisions on the radial direction determined by the maximum curvature of the cornea.

RESULTS:The difference of visual acuity between two groups at 1wk, 1,3mo after surgeries was not statistically significant(P>0.05). Corneal astigmatism of group A at 1wk and 1mo after surgeries were 4.03±0.41, 3.72±0.35D, respectively, and those of group B were 2.96±0.38, 1.29±0.15D, which were increased compared to those before surgeries. The post-operative corneal astigmatism of group A were significant higher than those of group B(P<0.05). At 3mo after surgeries, the difference of corneal astigmatism between the two groups was not statistically significant(P>0.05). The most common axis of the two groups preoperatively was astigmatism against the rule. At 1wk after surgeries, astigmatism with the rule increased, and the difference of astigmatism with the rule before and after surgeries was significant(P<0.05). The astigmatism with the rule decreased, astigmatism against the rule increased at 1 and 3mo after surgeries, which approximated that before surgeries. The differences of astigmatic axis between the two groups at different time points were not significant(P>0.05).

CONCLUSION:The transparent corneal phacoemulsification incision in the cornea astigmatism maximum radial direction can effectively reduce early postoperative astigmatism, but has little effect on long-term corneal astigmatism and visual acuity. If the conditions permit, doctors can create the corneal incision this way. But considering the increased complexity of the surgery, this is little meaningful.