European Journal of Molecular & Clinical Medicine

Surgically induced astigmatism (SIA) is a major obstacle in achieving good UCVA following cataract surgery. The size, location and architecture of the incision are considered very important for postoperative astigmatism. We aimed to compare the surgically induced astigmatism after phacoemulsification by temporal clear corneal versus superior clear corneal approach.
Methods: This was a prospective, randomized, interventional, parallel-group study that included 112 eyes of 112 senile cataract patients, undergoing phacoemulsification with foldable acrylic IOL implantation through an un-sutured 2.8 mm clear corneal incision at Ophthalmology department of Government Medical College Patiala, from February 2022 to July 2022. Patients were randomized into 2 groups: Group 1 underwent temporal incision phacoemulsification and Group 2 underwent superior incision phacoemulsification. Complete ophthalmological examination was done preoperatively and postoperatively after 7 days, 4 weeks and 6 weeks, including manifest refraction using an auto-refractometer and Snellen chart.
Results: The mean age of all participants was 59.09±12.8 (males vs. females; p=0.31). The mean preoperative astigmatism in all participants was 0.67 ± 0.39 (temporal vs superior incision; p=0.66) and at 6 weeks 0.87 ± 0.64 (temporal vs superior incision; p=0.21). Surgically induced astigmatism was found to be 0.73 ± 0.56 in temporal incision and 0.91 ± 0.36 in superior incision (p=0.04).
Conclusion: 2.8 mm clear corneal temporal incision phacoemulsification surgery causes less surgically induced astigmatism and mean total astigmatism as compared to 2.8 mm clear corneal superior incision phacoemulsification surgery

Context:
Keratoconus is non-inflammatory, asymmetrical, bilateral, and ectatic disease of the
cornea.[1] The diagnosis of advanced KCN can be easily made because of its characteristic
topographic and biomicroscopic findings, but identification of subclinical cases may be
extremely challenging. Detection of subclinical cases is important prior to refractive surgeries
as it can aggravate the progression of ectasia. [6]
Aims: The present study was aimed at investigating the prevalence of keratoconus and
subclinical keratoconus in Indian population with astigmatism more than 2 D by Pentacam
derived parameters and comparison of parameters among these groups.
Settings and Design: In this cross-sectional study, 50 patients (100 eyes) with astigmatism
>2D who were referred to the Outpatient Department of Ophthalmology in Government
Medical College Patiala were recruited.
Methods and Material:All of the patients underwent a complete ophthalmic examination
including refraction, retinoscopy, visual acuity, slit lamp biomicroscopy, posterior segment
examination and corneal topography with Pentacam.
Statistical analysis used:The collected data were analysed using Mann-Whitney U Test
using SPSS version 20.0.
Results:Mean age of the study population was 27±6.7 (range 16-45) years ofwhich 24 (52%)
were female and 26 (48%) were male subjects. In this present study, 6% of patients with
astigmatism >2D had keratoconus and 9% had subclinical keratoconus.
Conclusions:
Maximum keratometry, index of surface variance, index of vertical asymmetry, keratoconus
index and anterior and posterior elevation values were significantly higher and thinnest
pachymetry was significantly lower in eyes with clinical or subclinical KCN than normal
astigmatic eyes (P< 0.05).

Objective: To study the prevalence, amount and axis of pre-existing corneal
astigmatism in patients undergoing cataract surgery.
Methods: The study was carried out at a tertiary care ophthalmic institute in Prayagraj,
in patients admitted for cataract surgery from July 2017 to December 2017. In this
prospective study, patients aged 36-85 years of both genders were included and
statistically analysed. A Bausch and Lomb Manual keratometer was used for
measurement of keratometry. Only eyes without a previous history of ocular surgery or
any eye abnormality were included.
Results: Out of 997 patients,with-the-rule (WTR) astigmatism was found in 429 patients
(43%) and against-the-rule (ATR) astigmatism was found in 389 patients (39%) while
no astigmatism was found in 179 patients(18%).In females, WTR astigmatism was
found in 226 (41%) eyes; ATR astigmatism in 229 (42%) eyes; and no astigmatism in 94
(17%)eyes. In males, WTR astigmatism was found in 203 (45%) eyes; ATR astigmatism
in 160 (36%) eyes; and no astigmatism in 85 (19%) eyes. The most prevalent
astigmatism in this study was<1D (with average amount of astigmatism +0.80D.)
Conclusion:Most frequently observedpre-existing corneal astigmatism in this study is<1
D.WTR astigmatism is found to be more common in younger patients which shifts to
ATR astigmatism in older patients which is more evident in females. This can be easily
corrected with appropriate measures like limbal or corneal relaxing incisions,excimer
laser refractive procedures,femto laser assisted astigmatic keratectomy or toric IOL
implantation.

BACKGROUND-One of the most common cause for headache among patients attending
ophthalmic OPD is uncorrected refractive errors. The purpose of this study is to evaluate
the role of refractive errors in the etiology of headache.
MATERIALS AND METHODS-450 patients with headache attending eye OPD in GMC
Jammu were included in the study. It was a crosssectional study. They were subjected to
visual acuity examination, refraction, slit lamp examination, fundus examination and
retinoscopy wherever required
RESULTS- Out of the total patients 40% were males and 60% were females. 41.1% of the
patients had astigmatism, 31.1% of the patients had hypermetropia. chronic type of
headache was more common (46.7%) followed by subacute 33% and acute in 20.3%. We
found that headache was seen more commonly in frontal area (57.8%) followed by
occipital (32%) and combined (10.2%). The most common type of refractive error in these
patients was astigmatism 41.1% followed by hypermetropia 31.1% followed by presbyopia
16.7% followed by myopia 11.1%. Amount of refractive error between 1.25D -1.5D was
seen in 40% of the patients, followed by 1.5 -2D seen in 24.4%, followed by refractive error
less than 1.25D seen in 20 % of the patients, followed by refractive error more than 2D
seen in 15.6% of the patients. After optical correction there was improvement in headache
of patients.
CONCLUSION- Refractive errors play a major role in the Etiology of headache, which
can be managed by appropriate correction of these refractive errors. So, early Diagnosis
and adequate treatment is important.