{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:06:31Z","timestamp":1790996791286,"version":"4.1.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate the effect of opposite clear corneal incisions (OCCI) with 4 mm incisions on the steep meridian on postoperative astigmatism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study was performed on 64 eyes of 55 patients with keratometric astigmatism of \u2265 1 diopter (D) undergoing phacoemulsification. Patients were divided into two groups, with-the-rule (WTR) astigmatism and against-the-rule (ATR) astigmatism. Initial incisions in the WTR group were performed on the temporal side with 3.2 mm keratome and paired stab incisions were performed on the steep meridian. At the end of the surgery, stab incisions were enlarged to 4 mm. Follow-up visits were scheduled at 1, 3, 6, and 12 months postoperatively, which included refraction and keratometry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      It was found that the mean preoperative keratometric astigmatism was 2.06 \u00b1 0.86 D. The postoperative mean keratometric astigmatism was 1.3 \u00b1 0.7 D after 1 month and 1.2 \u00b1 0.7 D after 12 months. The mean astigmatism correction between the preoperative measure and that taken at 1 month was statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001), but there was no significant change in the severity of astigmatism afterward. The mean surgically-induced astigmatism was found to be 1.99 \u00b1 0.9 D. The 12-month changes of mean absolute astigmatism were: 1.06 \u00b1 0.7 D in the WTR group, and 0.53 \u00b1 0.7 D in the ATR group. The difference between the two groups was statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Based on our findings, we posit that paired OCCI on the steep axis, using 4 mm incisions is an effective technique to correct preoperative astigmatism.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joco.joco_205_20","type":"journal-article","created":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T01:10:45Z","timestamp":1641431445000},"page":"400-407","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Paired Opposite 4 Mm Clear Corneal Incisions on Steep Meridian During Phacoemulsification"],"prefix":"10.4103","volume":"33","author":[{"given":"Nazanin","family":"Binayi Faal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habib","family":"Ojaghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeid","family":"Sadeghieh Ahari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-5-20240910","first-page":"305","article-title":"Opposite clear corneal incisions versus on-axis incision during phacoemulsification to correct pre-existing astigmatism","volume":"13","author":"Bazzazi","year":"2008","journal-title":"Bina J Ophthalmol"},{"key":"R2-5-20240910","first-page":"303","article-title":"Prevalence of types of corneal astigmatism before cataract surgery","volume":"12","author":"Najafi","year":"2020","journal-title":"Int J Pharm Res"},{"key":"R3-5-20240910","doi-asserted-by":"crossref","first-page":"17","DOI":"10.4103\/1735-1995.200267","article-title":"Femtosecond laser arcuate keratotomy for the correction of postkeratoplasty high astigmatism in keratoconus","volume":"22","author":"Hashemian","year":"2017","journal-title":"J Res Med Sci"},{"key":"R4-5-20240910","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1016\/S0886-3350(00)00484-3","article-title":"Controlling astigmatism in cataract surgery requiring relatively large self-sealing incisions","volume":"26","author":"Akura","year":"2000","journal-title":"J Cataract Refract Surg"},{"key":"R5-5-20240910","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/S0886-3350(00)00378-3","article-title":"Opposite clear corneal incisions to correct pre-existing astigmatism in cataract surgery","volume":"26","author":"Lever","year":"2000","journal-title":"J Cataract Refract Surg"},{"key":"R6-5-20240910","first-page":"485","article-title":"Astigmatism control","volume":"19","author":"Nichamin","year":"2006","journal-title":"Ophthalmol Clin North Am"},{"key":"R7-5-20240910","first-page":"269","article-title":"Comparison of toric intraocular lens implantation, limbal relaxing incisions and opposite clear corneal incision for management of co-existing astigmatism on cataract surgery","volume":"33","author":"Koyun","year":"2018","journal-title":"Medeni Med J"},{"key":"R8-5-20240910","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1097\/ICO.0000000000000441","article-title":"Effect of paired opposite clear corneal incisions on with-the-rule versus against-the-rule astigmatism","volume":"34","author":"Chiam","year":"2015","journal-title":"Cornea"},{"key":"R9-5-20240910","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jcrs.2008.09.027","article-title":"Prevalence of corneal astigmatism before cataract surgery","volume":"35","author":"Ferrer-Blasco","year":"2009","journal-title":"J Cataract Refract Surg"},{"key":"R10-5-20240910","doi-asserted-by":"crossref","first-page":"494","DOI":"10.5301\/ejo.5000415","article-title":"Prevalence of corneal astigmatism before cataract surgery in Caucasian patients","volume":"24","author":"De Bernardo","year":"2014","journal-title":"Eur J Ophthalmol"},{"key":"R11-5-20240910","first-page":"1175","article-title":"Ragenos astigmatizmo korekcija darant kataraktos operacij\u0105","volume":"39","author":"\u017demaitien\u0117","year":"2003","journal-title":"Medicina"},{"key":"R12-5-20240910","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0886-3350(00)00798-7","article-title":"Astigmatism analysis by the Alpins method","volume":"27","author":"Alpins","year":"2001","journal-title":"J Cataract Refract Surg"},{"key":"R13-5-20240910","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/S0886-3350(13)80617-7","article-title":"A new method of analyzing vectors for changes in astigmatism","volume":"19","author":"Alpins","year":"1993","journal-title":"J Cataract Refract Surg"},{"key":"R16-5-20240910","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/S0886-3350(03)00649-7","article-title":"Opposite clear corneal incisions on the steep meridian in phacoemulsification: Early effects on the cornea","volume":"30","author":"Tadros","year":"2004","journal-title":"J Cataract Refract Surg"},{"key":"R17-5-20240910","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1007\/s00417-004-1035-3","article-title":"Correction of pre-existing astigmatism during cataract surgery: Comparison between the effects of opposite clear corneal incisions and a single clear corneal incision","volume":"243","author":"Ben Simon","year":"2005","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"R18-5-20240910","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1016\/j.jcrs.2006.04.010","article-title":"Corneal astigmatism correction with opposite clear corneal incisions or single clear corneal incision: Comparative analysis","volume":"32","author":"Khokhar","year":"2006","journal-title":"J Cataract Refract Surg"},{"key":"R19-5-20240910","first-page":"151","article-title":"Astigmatism; Managment of pre-existing astigmatism with 3.2 mm clear corneal incsion on steeper axis during phacoemulsification cataract surgery","volume":"26","author":"Alam","year":"2019","journal-title":"Prof Med J"},{"key":"R20-5-20240910","doi-asserted-by":"crossref","first-page":"676","DOI":"10.5301\/ejo.5000428","article-title":"Paired opposite clear corneal incision: Time-related changes of its effect and factors on which those changes depend","volume":"24","author":"Nemeth","year":"2014","journal-title":"Eur J Ophthalmol"},{"key":"R21-5-20240910","doi-asserted-by":"crossref","first-page":"241","DOI":"10.7869\/djo.182","article-title":"Evaluation of opposite clear corneal incision in controlling astigmatism in cataract patients undergoing phacoemulsification surgery","volume":"26","author":"Bhalla","year":"2016","journal-title":"Delhi J Ophthalmology"},{"key":"R22-5-20240910","first-page":"182","article-title":"Evaluation of Surgically Induced Astigmatism (SIA) in 2.8 mm superior clear corneal incision after phacoemulsification","volume":"19","author":"Singh","year":"2017","journal-title":"JK Sci"},{"key":"R23-5-20240910","doi-asserted-by":"crossref","first-page":"163","DOI":"10.4103\/2277-9175.139126","article-title":"Corneal astigmatism change and wavefront aberration evaluation after cataract surgery: \u201cSingle\u201d versus \u201cpaired opposite\u201d clear corneal incisions","volume":"3","author":"Razmjoo","year":"2014","journal-title":"Adv Biomed Res"}],"container-title":["Journal of Current Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joco.joco_205_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:53:06Z","timestamp":1787755986000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joco.joco_205_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/joco.joco_205_20","relation":{},"ISSN":["2452-2325"],"issn-type":[{"value":"2452-2325","type":"print"}],"subject":[],"published":{"date-parts":[[2021,10]]}}}