# Visual and refractive outcomes of opposite clear corneal incision combined with rotationally asymmetric multifocal intraocular lens implantation

## TL;DR

This study compares surgical techniques for cataract patients with astigmatism, finding that opposite incisions improve visual outcomes.

## Contribution

The study demonstrates that opposite clear corneal incisions reduce residual astigmatism when used with multifocal lenses.

## Key findings

- OCCI group had lower residual astigmatism (-0.60 ± 0.29 D) compared to SCCI group (-1.18 ± 0.47 D).
- Vector analysis showed significant differences in astigmatism correction metrics between the two groups.
- OCCI combined with multifocal IOLs provided predictable efficacy for astigmatic cataract patients.

## Abstract

To evaluate the visual and refractive outcomes of astigmatic cataract patients following opposite clear corneal incision (OCCI) combined with rotationally asymmetric multifocal intraocular lens (IOL) implantation.

Department of Ophthalmology, Zhongshan Hospital (Xiamen), Fudan University, People’s Republic of China.

Retrospective cohort study.

This study comprised 58 cataract eyes of 54 patients with corneal astigmatism who underwent phacoemulsification and rotationally asymmetric multifocal IOL implantation which received either OCCI (OCCI group) or a single clear corneal incision (SCCI group). The follow-up period was 3 months after surgery. Distance, intermediate and near visual acuity, refractive outcomes, and corneal anterior keratometry were compared between the two groups. Vector analysis was used to evaluate astigmatism correction.

Three months after surgery, the distance, intermediate and near visual acuity, and sphere remained comparable between the two groups, but a significant difference was detected in residual astigmatism and anterior corneal keratometric astigmatism. In the OCCI group, the residual astigmatism and keratometric astigmatism were −0.60 ± 0.29 D and 0.59 ± 0.28 D, respectively, which were lower than those in SCCI groups (−1.18 ± 0.47 D and 1.15 ± 0.45 D, both p < 0.05). In vector analysis, the difference vector (DV), angle of error (AoE), absolute AoE, index of success (IoS) and correction index (CI) were statistically significantly different between the two groups (p < 0.05).

OCCI combined with rotationally asymmetric multifocal intraocular lens implantation showed predictable and desirable efficacy in treating cataract patients with astigmatism.