title: Prospective randomized comparison of phacoemulsification cataract surgery with a 3.2-mm vs a 5.5-mm sutureless incision.
abstract: OBJECTIVE
  To report sutureless cataract surgery by phacoemulsification with a 3.2-mm surgical incision compared with a 5.5-mm surgical incision.
  
  
  METHODS
  In a prospective, randomized, masked clinical trial of phacoemulsification cataract surgery, 55 eyes (55 patients) had a 3.2-mm incision and 56 eyes (56 patients) had a 5.5-mm incision. All incisions were in the superior vertical meridian, commenced 1.5 mm posterior to the limbus, and extended into the cornea for a total length of 2.5 to 3.0 mm. In a masked fashion, astigmatism was monitored by keratometry, and logMAR visual acuity was determined both with and without best correction throughout a mean follow-up of 33.9 months.
  
  
  RESULTS
  Statistically significant differences were seen in favor of the 3.2-mm incision group at the final examination for astigmatism (Cravy analysis) and uncorrected visual acuity (-0.18 vs -0.88 diopter, P < .001; logMAR, 0.14 vs 0.26, P = .04).
  
  
  CONCLUSIONS
  Over the long term, phacoemulsification with a 3.2-mm incision is associated with significantly less astigmatic shift and better uncorrected visual acuity than is phacoemulsification with a 5.5-mm incision. A small incision with a foldable intraocular lens has long-term benefits.
authors.affiliation: Ophthalmology Department, University of Utah Health Sciences Center, Salt Lake City, USA. randall.olson@hsc.utah.edu
authors.forename: R J
authors.initials: RJ
authors.lastname: Olson
authors.forename: A S
authors.initials: AS
authors.lastname: Crandall
mesh_terms: D000368:Aged; D001251:Astigmatism / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D019904:Polymethyl Methacrylate; D011446:Prospective Studies; D012826:Silicone Elastomers; D016037:Single-Blind Method; D013536:Suture Techniques / Q000009:adverse effects; D014792:Visual Acuity
chemical_list: D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate