title: Biaxial microincision versus coaxial small-incision cataract surgery in complicated cases.
abstract: OBJECTIVE
  To evaluate and compare the results of biaxial microincision and coaxial small-incision surgery in patients with cataract with coexisting exfoliation syndrome, uveitis, anterior or posterior synechias, phacodonesis, or previous intraocular surgery over an 8-week follow-up.
  
  
  METHODS
  Department of Ophthalmology, Mainz University, Mainz, Germany.
  
  
  METHODS
  Eyes were prospectively assigned (1:1) to have biaxial microincision (<1.5 mm) phacoemulsification or coaxial small-incision (2.8 mm) phacoemulsification using pulsed ultrasound energy (Sovereign WhiteStar) with variable duty cycles followed by implantation of a microincision intraocular lens. Intraoperative and postoperative complications, corrected distance visual acuity (CDVA), laser flare photometry values, effective phacoemulsification time (EPT), and endothelial cell count (ECC) were evaluated.
  
  
  RESULTS
  The study enrolled 94 eyes. There were no statistically significant differences between the techniques in intraoperative or postoperative complications. The most frequent postoperative complications were corneal edema surrounding the incision (40%, biaxial group; 35%, coaxial group), pupil distortion (3% versus 7%), and fibrin exudation (3% versus 3%). No other postoperative complications occurred. The median EPT was statistically significantly shorter (1.34 seconds versus 5.4 seconds) and the median phaco power significantly lower (3.3% versus 12.9%) in the biaxial group than in the coaxial group (P<.001). There were no differences between groups in CDVA, laser flare photometry values, or ECC.
  
  
  CONCLUSIONS
  The EPT was shorter and the mean phaco power lower with biaxial phacoemulsification, perhaps because of better access of the phaco handpiece for grooving the nucleus with this technique. The 2 techniques were comparable in intraoperative and postoperative complications.
  
  
  BACKGROUND
  No other author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. sab.schmitz@t-online.de
authors.forename: Sabine
authors.initials: S
authors.lastname: Kurz
authors.forename: Frank
authors.initials: F
authors.lastname: Krummenauer
authors.forename: Hagen
authors.initials: H
authors.lastname: Thieme
authors.forename: H Burkhard
authors.initials: HB
authors.lastname: Dick
mesh_terms: D000368:Aged; D002386:Cataract / Q000150:complications*; D002452:Cell Count; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007431:Intraoperative Complications; D007905:Lens Diseases / Q000150:complications*; D019654:Lens Implantation, Intraocular; D008297:Male; D008866:Microsurgery / Q000379:methods*; D018918:Phacoemulsification / Q000379:methods*; D010783:Photometry; D011183:Postoperative Complications; D011446:Prospective Studies; D013997:Time Factors; D014605:Uveitis / Q000150:complications*; D014792:Visual Acuity / Q000502:physiology