Corneal higher-order aberrations after phacoemulsification: a comparison of 3 different incision sizes



To analyze the impact of different incision sizes for phacoemulsification on corneal higher-order aberrations (HOA).


Patients seeking cataract surgery were randomly assigned to one of the following groups: 1.4 mm with biaxial microincision phacoemulsification (25 eyes), 1.8 mm with coaxial phacoemulsification (27 eyes), and 2.2 mm with coaxial phacoemulsification (62 eyes). Inclusion criteria were a minimum age of 18 years and uncomplicated cataract. Exclusion criteria were history of ocular trauma or intraocular surgery, any sign of inflammation or infection, pseudoexfoliation syndrome, glaucoma, optic atrophy, diabetic retinopathy, lens dislocation, cataracta intumescens, cataracta matura, and corneal diseases. Patients underwent phacoemulsification with implantation of an intraocular lens. Aberrometry was performed using an iTrace aberrometer with a pupil scan size of 5.0 mm preoperatively and at postoperative follow-up visits after 1 month. The paired sample t test and analysis of covariance were used for statistical analysis.


Ninety patients (114 eyes) were enrolled (mean age 73.7 ± 8.9 years). In all groups, an increase of total HOAs could be measured. The strongest increase was seen in the 2.2 mm group (mean difference 0.031 [95% confidence interval (CI) 0.006-0.056], p = 0.014) and in the 1.4 mm group (mean difference 0.035 [95% CI -0.007 to 0078], p = 0.097). No important difference was found in the 1.8 mm group.


The 2.2 mm and the 1.4 mm incisions seem to have a higher impact on corneal HOAs in comparison to the 1.8 mm incision.

Eur J Ophthalmol 2017; 27(4): 402 - 406




Christoph von Sonnleithner, Daniel Pilger, David Homburg, Tobias Brockmann, Necip Torun, Eckart Bertelmann

Article History


Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.
Meeting presentation: Poster presentation at the congress of the German Ophthalmological Society (DOG); 1-4 October 2015, Berlin, Germany.

This article is available as full text PDF.

  • If you are a Subscriber, please log in now.

  • Article price: Eur 36,00
  • You will be granted access to the article for 72 hours and you will be able to download any format (PDF or ePUB). The article will be available in your login area under "My PayPerView". You will need to register a new account (unless you already own an account with this journal), and you will be guided through our online shop. Online purchases are paid by Credit Card through PayPal.
  • If you are not a Subscriber you may:
  • Subscribe to this journal
  • Unlimited access to all our archives, 24 hour a day, every day of the week.



  • Department of Ophthalmology, Charité-Medical University Berlin, Campus Virchow, Berlin - Germany
  • Christoph von Sonnleithner and Daniel Pilger contributed equally to this work.

Article usage statistics

The blue line displays unique views in the time frame indicated.
The yellow line displays unique downloads.
Views and downloads are counted only once per session.

No supplementary material is available for this article.