Comparison of microcoaxial with standard clear corneal incisions in torsional handpiece cataract surgery.

AIM

To evaluate the effect of torsional handpiece incision size on phacodynamics and endothelial cell loss (ECL) in cataract surgery.

DESIGN

Prospective, observer-masked study at the Department of Ophthalmology and Visual Science, Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.

PARTICIPANTS

This study was conducted on 60 eyes of 60 patients who underwent phacoemulsification.

METHODS

Cataract surgery was performed on 28 eyes using a 0.9-mm micro 45-degree Kelman ABS (aspiration bypass system) tip through a 2.8-mm standard incision, and on 32 eyes using a 0.9-mm mini-flared 45-degree Kelman ABS tip through a 2.2-mm microcoaxial incision. As main outcome measures, intraoperative phacodynamics (cumulative dissipated energy, CDE, and balanced salt solution, BSS, use), central corneal thickness (CCT) and endothelial cell count (ECC) were investigated.

RESULTS

The CDE was lower in the microcoaxial incision (2.2-mm) group than in the standard incision (2.8-mm) group (p = 0.038). The ECC loss at 6 months was significantly lower in the microcoaxial incision group than in the standard incision group (p = 0.048). There were no differences in BSS use or CCT between the two groups.

CONCLUSIONS

Torsional ultrasound phacoemulsification using microcoaxial incision with a mini-flared tip resulted in less energy use and less ECL compared with standard incision with a micro tip.