Is opposite clear cornea incision useful still? – A tertiary institute experience

Objectives: Paired opposite clear corneal incision (OCCI), placed at the steepest meridian, during phacoemulsification cataract surgery is one of the options used to improve pre-existing astigmatism, which enhances the flattening effect. Our surgical technique for OCCI consists of a 2.75-mm stab clear corneal incision with a steel microkeratome. In this series, we retrospectively review the effect of OCCI on reducing preoperative corneal astigmatism done by a single surgeon. Materials and Methods: From October 2021 to May 2022, 53 eyes underwent phacoemulsification cataract surgery with OCCI. All eyes completed refractive analysis at least at postoperative month 1. Results: There were 22 males (45.1%) and overall mean age was 70.8years. Mean corneal astigmatism preoperatively was -1.98±0.57D. At postoperative month 1, the mean change in spherical equivalence was 0.97 ± 2.8D ( P = 0.37). The mean reduction in corneal astigmatism was 1.07±0.83D ( P <.001). At postoperative month 6 ( n = 17), mean reduction in corneal astigmatism compared to preoperatively was 0.89±0.74D ( P = <0.001). Mean corneal astigmatism increased between postoperative month 1 and month 6 at 0.15 ± 0.79D but this was not statistically significant. Age was not found to be correlated to change in astigmatism (r = 0.156). Conclusion: Paired OCCI is a useful technique to correct pre-existing astigmatism with no additional need to alter surgical setting.