Abstract Objective To compare the changes of wavefront aberrations of the corneal anterior surface between different clear corneal incision position (incision on the steepest corneal meridian and incision on the superior position) in phacoemulsification. Methods Forty-six patients (62 eyes) were selected and divided into control group (incision on the superior position, 32 eyes of 24 patients)and test group (incision on the steepest corneal meridian, 30 eyes of 22 patients) according to the position of incision. Examinations of the best corrected visual acuity (BCVA) and corneal topography were carried out before cataract surgery and 1 week, 1 month, 3 months after surgery. Results The differences of BCVA (logMAR) between the two groups before cataract surgery and 1 week, 1 month,3 months after surgery were not significant (P>0.05). The corneal astigmatism in test group 1 week,1 month and 3 months postoperative were significantly smaller than those of preoperation (P<0.05).the corneal spherical aberrations (diameter at 5.0 mm and 6.0 mm) in test group 1 week postoperative were significantly smaller than those of preoperations (P<0.05), the corneal total higher-order wavefront aberrations (HOA) (diameter at 4.0 mm, 5.0 mm and 6.0 mm), coma(diameter at 4.0 mm, 5.0 mm and 6.0 mm), spherical aberrations (diameter at 5.0 mm and 6.0 mm) and trefoil (diameter at 4.0 mm,5.0 mm and 6.0 mm) in test group 1 month postoperative were significantly larger than those of 1 week postoperative (P<0.05), the corneal trefoil (diameter at 4.0 mm, 5.0 mm and 6.0 mm) in test group 3 months postoperatively were significantly smaller than those of 1 month postoperative (P<0.05).The axial direction of corneal coma and trefoil in test group and control group 1 month and 3 months postoperative turned to the incision direction obviously. Conclusion The study shows that eyes with incision on the steepest corneal meridian can reduce the corneal astigmatism, and the size and orientation of corneal higher-order wavefront aberrations.
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