Clinical evaluation of three incision size-dependent phacoemulsification systems.
OBJECTIVE
To compare the outcomes of cataract surgery performed with 3 incision size-dependent phacoemulsification groups (1.8, 2.2, and 3.0 mm).


METHODS
Prospective randomized comparative study.


METHODS
One hundred twenty eyes of 120 patients with age-related cataract (grades 2 to 4) were categorized according to the Lens Opacities Classification System III. Eligible subjects were randomly assigned to 3 surgical groups using coaxial phacoemulsification through 3 clear corneal incision sizes (1.8, 2.2, and 3.0 mm). Different intraoperative and postoperative outcome measures were obtained, with corneal incision size and surgically induced astigmatism as the main clinical outcomes.


RESULTS
There were no statistically significant differences in most of the intraoperative and postoperative outcome measures among the 3 groups. However, the mean cord length of the clear corneal incision was increased in each group after surgery. The mean maximal clear corneal incision thickness in the 1.8-mm group was significantly greater than for the other groups at 1 month. The mean surgically induced astigmatism in the 1.8- and 2.2-mm groups was significantly less than that in the 3.0-mm group after 1 month, without significant difference between the 1.8- and 2.2-mm groups.


CONCLUSIONS
With appropriate equipment, smaller incisions may result in less astigmatism, but the particular system used will influence incision stress and wound integrity, and may thus limit the reduction in incision size and astigmatism that is achievable.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Lixia
L
Luo
Haotian
H
Lin
Mingguang
M
He
Nathan
N
Congdon
Ye
Y
Yang
Yizhi
Y
Liu
D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging; D001251:Astigmatism / Q000503:physiopathology / Q000517:prevention & control*; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014463:Ultrasonography; D014792:Visual Acuity / Q000502:physiology; D014945:Wound Healing / Q000502:physiology