Surgically induced astigmatism and posterior corneal curvature changes following phacoemulsification.

PURPOSE: To primarily compare surgically induced astigmatism (SIA), total and posterior corneal curvature, pachymetry, and their stabilization after 2.2 and 2.8 mm clear corneal incision in phacoemulsification. METHODS: A randomized, prospective interventional study of 130 patients (130 eyes) of either sex having senile cataract (>40 years) divided randomly into two groups. The patients underwent uncomplicated phacoemulsification surgery with foldable intraocular lens implantation using 2.2 mm (group 1) and 2.8 mm incisions (group 2). The patients were evaluated preoperatively and followed-up at first, third, and sixth weeks. RESULTS: Mean SIA was less in group 1 at all the follow-up visits which was not statistically significant (P value - 0.507 (at week 1), 0.626 (at week 3), and 0.312 (at week 6). Mean SIA decreased from week 1 to week 6 in both the groups. Both the groups showed an increase in SIA with the increase in the hardness of cataract. Posterior keratometry (k1 and k2) showed statistically significant steepening in the first postoperative week, followed by gradual flattening which continued till the sixth week postoperatively. Posterior astigmatism increased in both the groups at week 1 (not statistically significant). Thereafter, it decreases and does not change significantly after 3 weeks. Pachymetry increased significantly (P value < 0.001 in both the groups) in the first week in both the groups and thereafter stabilizing at 3 weeks. CONCLUSION: Reducing the incision size does not result in any significant reduction in SIA. We observed that the posterior corneal curvature majorly stabilized by 3 weeks, but some stabilization continued till 6 weeks.

Choroidal osteoma: the varied response of subretinal fluid to anti-VEGF agents.

The present case shows a remarkable long-term response of the choroidal neovascular membrane and serous retinal detachment associated with choroidal osteoma to two injections of ranibizumab which is an anti-vascular endothelial growth factor (anti-VEGF) agent.