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Peer-reviewedCC BYFrontiers in Medicine

Effect of steep-axis incisions on anterior and posterior corneal astigmatism and higher-order aberrations after cataract surgery

  • Kaiyue Du1
  • Kaiyue Du2
  • Zhan Shen1
  • Zhan Shen2
  • Bowei Yuan1
  • Bowei Yuan2
  • Yinan Liu1
  • Yinan Liu2
  • Xiaoyong Chen1
  • Xiaoyong Chen2
  • Jing Hong1
  • Jing Hong2
  1. 1Department of Ophthalmology, Peking University Third Hospital, Beijing, China
  2. 2Department of the Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing, China
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Abstract

PurposeTo compare the effects of steep-axis versus superior corneal incisions on visual acuity, astigmatism correction, and higher-order aberrations (HOAs) in patients undergoing phacoemulsification with intraocular lens implantation.DesignProspective, case-control, single-center study.MethodsThis study enrolled patients with preoperative corneal astigmatism <2.5 diopters. Outcomes included corrected distance visual acuity (CDVA), anterior and posterior corneal astigmatism, surgically induced astigmatism measured with Pentacam, and higher-order aberrations (HOAs) assessed using Pentacam and iTrace at 1 and 3 months postoperatively.ResultsA total of 148 right eyes from 148 patients were analyzed, including 56 in the steep-axis incision group and 92 in the superior-incision group. CDVA did not differ significantly between groups at 3 months (p = 0.617). Steep-axis incisions produced significantly lower anterior corneal astigmatism (p = 0.006) and a greater flattening effect (p < 0.001) at 3 months. No significant intergroup differences were observed in total HOAs of the total cornea, anterior cornea, or posterior cornea within the 6-mm zone by either Pentacam or iTrace. Subgroup analysis of steep-axis orientations (with-the-rule, against-the-rule, oblique) revealed no significant differences in outcomes.ConclusionSteep-axis incisions effectively reduce anterior corneal astigmatism without increasing HOAs, representing a practical option for correcting mild-to-moderate astigmatism in cataract surgery.

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Cite

BibTeXRIS
BibTeX
@article{du2026effect,
  title = {{Effect of steep-axis incisions on anterior and posterior corneal astigmatism and higher-order aberrations after cataract surgery}},
  author = {Kaiyue Du and Kaiyue Du and Zhan Shen and Zhan Shen and Bowei Yuan and Bowei Yuan and Yinan Liu and Yinan Liu and Xiaoyong Chen and Xiaoyong Chen and Jing Hong and Jing Hong},
  journal = {Frontiers in Medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fmed.2026.1948208},
  url = {https://doi.org/10.3389/fmed.2026.1948208},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Effect of steep-axis incisions on anterior and posterior corneal astigmatism and higher-order aberrations after cataract surgery
AU  - Kaiyue Du
AU  - Kaiyue Du
AU  - Zhan Shen
AU  - Zhan Shen
AU  - Bowei Yuan
AU  - Bowei Yuan
AU  - Yinan Liu
AU  - Yinan Liu
AU  - Xiaoyong Chen
AU  - Xiaoyong Chen
AU  - Jing Hong
AU  - Jing Hong
PY  - 2026
DA  - 2026/10/23
JO  - Frontiers in Medicine
DO  - 10.3389/fmed.2026.1948208
UR  - https://doi.org/10.3389/fmed.2026.1948208
AB  - PurposeTo compare the effects of steep-axis versus superior corneal incisions on visual acuity, astigmatism correction, and higher-order aberrations (HOAs) in patients undergoing phacoemulsification with intraocular lens implantation.DesignProspective, case-control, single-center study.MethodsThis study enrolled patients with preoperative corneal astigmatism <2.5 diopters. Outcomes included corrected distance visual acuity (CDVA), anterior and posterior corneal astigmatism, surgically induced astigmatism measured with Pentacam, and higher-order aberrations (HOAs) assessed using Pentacam and iTrace at 1 and 3 months postoperatively.ResultsA total of 148 right eyes from 148 patients were analyzed, including 56 in the steep-axis incision group and 92 in the superior-incision group. CDVA did not differ significantly between groups at 3 months (p = 0.617). Steep-axis incisions produced significantly lower anterior corneal astigmatism (p = 0.006) and a greater flattening effect (p < 0.001) at 3 months. No significant intergroup differences were observed in total HOAs of the total cornea, anterior cornea, or posterior cornea within the 6-mm zone by either Pentacam or iTrace. Subgroup analysis of steep-axis orientations (with-the-rule, against-the-rule, oblique) revealed no significant differences in outcomes.ConclusionSteep-axis incisions effectively reduce anterior corneal astigmatism without increasing HOAs, representing a practical option for correcting mild-to-moderate astigmatism in cataract surgery.
SN  - 2296-858X
ER  -