Temporal versus Superior Limbal Incision: Any difference in visual outcome? Initial report of 40 retrospective cases

Abstract

Aim: To compare the visual outcome of a superiorly placed limbal incision with a temporal limbal incision in extracapsular cataract surgery. The main outcome measures are visual acuity and the degree of stigmatism based on refraction.
Method: A retrospective non randomized comparative study. Medical records of 40 patients (40 eyes) who had uni-ocular extra-capsular cataract extraction over a 6-month period were used for the study. Relevant data
extracted included age and sex, presenting visual acuity, type of incision used for cataract extraction, visual acuity, and refraction results at the 13th postoperative week. The exclusion criteria were any visible ocular
condition that could affect visual acuity such as corneal scar, glaucoma or vitreous loss.
Results: A total of 40 cases were studied; 22 (55%) males and 18 (45%) females. About 65% (26) were aged 50-89 years; mean 50.12 years (SD=23.28). Twenty six patients (65%) had temporal limbal incision while 14 had superior limbal incision. Of these. 76.9% of the temporal limbal
incision group had VAs of 6/18 or better 6 weeks after surgery, compared to 64.3% for the superior limbal incision group (table 5). This difference was statistically significant (P=0.01). At the 13th postoperative week, 20
eyes (76.9%) had corrected visual acuities of 6/12 or better for the temporal incision group, and 6 eyes (42.9%) in the superior limbal incision group (table 6). This difference was however not statistically significant
(P=0.07). Most eyes (76.2%) in the temporal incision group had between 0.25DC-2.00DC of astigmatism compared to 46.2% in the superior limbal incision group who also had higher degrees of astigmatism (53.8%). This finding was however not statistically significant (P = 0.15) Conclusion: Temporal limbal incision has been shown to have a better visual outcome at 6 weeks postoperative (p=0.01) and a lower level of astigmatism compared to superior limbal incision at 13 weeks postoperative.

Key words: ECCE: temporal versus superior incision