Short-term influence of aspirating speculum use on dry eye after cataract surgery: a prospective study.

PURPOSE: The aim of this study was to investigate the short-term influence of the use of an aspirating speculum on dry eye after performing cataract surgery. METHODS: This study was conducted using a prospective, consecutive, comparative, interventional case series of 58 eyes of 58 patients who underwent clear corneal cataract surgery; 29 eyes were treated using an aspirating speculum, and 29 eyes were treated without using a nonaspirating speculum. The main outcome measures were sequential changes of dry eye parameters including conjunctival staining, tear film break-up time (tBUT), conjunctivochalasis grades, and ocular surface disease index (OSDI). RESULTS: In the nonaspirating speculum group, tBUT and conjunctivochalasis grades were aggravated on day 1 postoperatively (P < 0.001), but conjunctival staining and OSDI did not show any significant change during the follow-up. In the aspirating speculum group, significant aggravation was observed by conjunctival staining on day 1 postoperatively (P = 0.001), tBUT and conjunctivochalasis grades were evaluated on day 1 and day 7 postoperatively (P < 0.001), and the OSDI was evaluated on day 7 postoperatively (P = 0.011). CONCLUSIONS: The use of an aspirating speculum aggravated dry eye parameters during the early postoperative period. Although these parameters returned to their preoperative values at 1 month postoperatively, the use of an aspirating speculum has the potential to aggravate dry eyes after cataract surgery is performed.

Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery.

AIMS: To compare the corneal refractive changes induced after 3.0 mm temporal and nasal corneal incisions in bilateral cataract surgery. MATERIALS AND METHODS: This prospective study comprised a consecutive case series of 60 eyes from 30 patients with bilateral phacoemulsification that were implanted with a 6.0 mm foldable intraocular lens through a 3.0 mm horizontal clear corneal incision (temporal in the right eyes, nasal in the left eyes). The outcome measures were surgically induced astigmatism (SIA) and uncorrected visual acuity (UCVA) 1 and 3 months, post-operatively. RESULTS: At 1 month, the mean SIA was 0.81 diopter (D) for the temporal incisions and 0.92 D for nasal incisions (P = 0.139). At 3 months, the mean SIA were 0.53 D for temporal incisions and 0.62 D for nasal incisions (P = 0.309). The UCVA was similar in the 2 incision groups before surgery, and at 1 and 3 months post-operatively. CONCLUSION: After bilateral cataract surgery using 3.0 mm temporal and nasal horizontal corneal incisions, the induced corneal astigmatic change was similar in both incision groups. Especially in Asian eyes, both temporal and nasal incisions (3.0 mm or less) would be favorable for astigmatism-neutral cataract surgery.