Microcoaxial phacoemulsification Part 2: clinical study.

PURPOSE

To determine whether microcoaxial phacoemulsification can be reliably and safely performed in a clinical setting and whether a full-sized single-piece acrylic intraocular lens (IOL) can be implanted through a 2.2 mm incision.

SETTING

Private practice, Cincinnati, Ohio, USA.

METHOD

One hundred consecutive patients had cataract surgery by microcoaxial phacoemulsification with the MicroSmooth Ultrasleeve (Alcon Surgical) through a 2.2 mm incision. Anterior chamber stability, incision competency, safety of IOL implantation, intraoperative complications, efficiency, and the learning curve were evaluated. Uncorrected visual acuity (UCVA) on the first postoperative day, corneal appearance, intraocular pressure, and postoperative complications were also analyzed.

RESULTS

Anterior chamber stability and incision competency were consistently excellent. The incision enlarged from 2.2 mm to 2.3 mm in 80% of the patients, to 2.4 mm in 12%, and to 2.5 mm in 8%. A high-power IOL and/or IOL insertion difficulty may account for 7 of the latter 8 cases. Efficiency and safety were equivalent to those in traditional phacoemulsification. The learning curve with the Ultrasleeve was minimal, although IOL implantation was initially more difficult. The UCVA on the first postoperative day was 20/40 or better in 91% of patients, a result consistent with mild corneal edema. There were no postoperative complications.

CONCLUSIONS

The clinical results in a prospective series of 100 patients confirmed the efficacy and safety of microcoaxial phacoemulsification. Fluidic advantages, competent incisions, and the new countertraction implantation technique provide another approach to achieving less-invasive, high-quality cataract surgery.