Three year prospective, randomized evaluation of intraocular lens implantation through 3.2 and 5.5 mm incisions.
OBJECTIVE
To compare the long-term clinical results of two small incision cataract surgery procedures.


METHODS
Seven centers in Japan.


METHODS
Two hundred eyes were randomly assigned to receive a silicone intraocular lens (IOL) through a 3.2 mm incision or a poly(methyl methacrylate) (PMMA) IOL through a 5.5 mm incision. Except for incision size and implantation technique, the surgical methods were identical. Uncorrected and corrected visual acuity, keratometry, flare-cell intensity, specular microscopy, and neodymium:YAG (Nd:YAG) laser posterior capsulotomy rate were analyzed up to 3 years after surgery.


RESULTS
Eyes in the 3.2 mm incision group had significantly better uncorrected and corrected visual acuity in the early postoperative period and lower aqueous flare intensity immediately after surgery, but these differences disappeared after the first postoperative month. However, surgically induced astigmatism was significantly less in the 3.2 mm incision group than in the 5.5 incision group throughout the study. The Nd:YAG laser capsulotomy rate was higher in the silicone IOL group (23.5% at 3 years postoperatively) than in the PMMA IOL group (18.4%) but the difference was not statistically significant.


CONCLUSIONS
Smaller incision cataract surgery led to early recovery of visual function in the short term and less induced astigmatism in the long term.
Oshika
T
T
Department of Ophthalmology, University of Tokyo School of Medicine, Japan.
Nagahara
K
K
Yaguchi
S
S
Emi
K
K
Takenaka
H
H
Tsuboi
S
S
Yoshitomi
F
F
Nagamoto
T
T
Kurosaka
D
D
D000368:Aged; D001251:Astigmatism / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification; D019904:Polymethyl Methacrylate; D011446:Prospective Studies; D012826:Silicone Elastomers; D013536:Suture Techniques / Q000009:adverse effects; D016896:Treatment Outcome; D014792:Visual Acuity; D014945:Wound Healing
D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate