AIM: To compare the changes of surgically induced corneal higher-order aberrations after phacoemulsification with 2.8mm clear corneal incisions at different sites.

METHODS: The clinical data of 100 cases(100 eyes)of patients with cataract treated by phacoemulsification with 2.8mm clear corneal incision in our hospital from March 2015 to April 2016 were analyzed retrospectively. According to the site of incision, they were divided into Group A(temporal clear corneal incision, n=55)and Group B(upper clear corneal incision, n=45). Changes of the best corrected visual acuity(BCVA), surgically induced astigmatism(SIA)and corneal topography were compared between the two groups before surgery, at 1d, 1wk, 1 and 3mo after surgery. The corneal wavefront aberrations were measured by wavefront aberration analyzer, and the changes of higher-order aberrations in corneal 6mm range were recorded.

RESULTS: The BCVA of two groups decreased at 1d, 1wk, 1 and 3mo after surgery(P<0.05), and the BCVA of Group A at 1d, 1wk, and 1mo after surgery was lower than that of Group B(P<0.05). SIA of the two groups decreased at 1wk, 1 and 3mo after surgery(P<0.05), and the SIA of Group A at different time points after surgery were lower than those of Group B(P<0.05). The surface asymmetry index(SAI)and the surface rule index(SRI)of the two groups increased at 1d after surgery, and were gradually decreased at 1wk, 1 and 3mo after surgery. The SRI and SAI in Group A were lower than those in Group B at 1d and 1wk after surgery(P<0.05). The total corneal higher-order aberrations(tHOAs)and four-order spherical aberration(SA)showed significant differences between the two groups at 3mo after surgery(P<0.05).

CONCLUSION: The application of 2.8mm temporal clear corneal incision in phacoemulsification can promote the recovery of visual acuity, reduce the effect of surgery on corneal shape, and reduce corneal higher-order aberrations.