Evidence map›Paper›PMID 39800371›Full record

ArticleBMJ open ophthalmology2025

Cataract surgery has minimal effect on corneal shape.

Fadi Alfaqawi, Luca Pagano, Esmaeil M Arbabi, Vito Romano, Ahmed Al-Maskari, Keri McLean, Gabriella Czanner, Stephen B Kaye

Abstract read
In one paragraph

Article in BMJ open ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Fadi AlfaqawiRoyal Liverpool University Hospital, Liverpool, UK.ORCID 0000-0002-0957-3222
Luca PaganoOphthalmology, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK.ORCID 0000-0001-8534-6817
Esmaeil M ArbabiRoyal Liverpool University Hospital, Liverpool, UK.
Vito RomanoEye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy Vito.Romano@unibs.it.ORCID 0000-0002-5148-7643
Ahmed Al-MaskariRoyal Liverpool University Hospital, Liverpool, UK.
Keri McLeanRoyal Liverpool University Hospital St Paul's Eye Unit, Liverpool, UK.ORCID 0000-0002-8907-1176
Gabriella CzannerLiverpool John Moores University, Liverpool, UK.
Stephen B KayeDepartment of Eye and Vision Science, University of Liverpool, Liverpool, UK.ORCID 0000-0003-0390-0592

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo quantify the effect of cataract surgery on cornea shape.

methodsPatients undergoing cataract surgery with standardised 2.75 mm surgical incisions at 110 degrees with a side port at 50 degrees were included. Repeat biometric measurements were taken before surgery and at 6 weeks on both operated and unoperated fellow eyes. Data were transformed into Long's formalism for analysis. Device-specific measurement error was determined. The main outcome measure was the change in keratometry taking into account the change in keratometry of the unoperated fellow eye. Secondary outcome measures included the variability introduced due to location of the incision.

results132 patients were included. The mean change in keratometry of the operated eye was -0.23@111/+0.21@21 (95% CI -1.43@122/+0.04@32 to +1.04@135/+0.30@45). The flattening effect of the surgical incision was greater and more variable than the steepening effect (p<0.01), particularly if the incision was in the flat meridian. Coupling, defined as ratio of the keratometric change in the preoperative meridians of K2 and K1, varied from 0.91 (SD 2.31) for eyes with an incision in the steep meridian, 0.75 (SD 1.81) for an incision in the flat meridian to 0.28 (SD 2.06) when the incision was made in a neutral meridian.

conclusionCataract surgery has a slightly greater flattening than steepening effect on corneal shape. Although the effects are very small and variable with incomplete coupling, it is preferable to place the incision in the steep meridian. Greater emphasis, however, should be placed on eye-specific factors, such as biometry, or patient-related factors to optimise refractive outcomes.

Indexed as

Cataract ExtractionCorneaPhacoemulsificationAgedAged, 80 and overBiometryCorneal TopographyFemaleHumansLens Implantation, IntraocularMaleMiddle AgedProspective StudiesVisual AcuityCataractCorneaOptics and Refraction

Identifiers

PMID39800371
PMCPMC11891536

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