Clinical evaluation on the bimanual microincision cataract surgery

Abstract

To compare the outcomes of bimanual microincision phacoemulsification with conventional small incision cataract surgery. A randomized prospective study of 280 consecutive cases (280 eyes) was conducted. All patients were randomly assigned to receive bimanual microincision cataract surgery (MICS group) or small incision cataract surgery (SICS group). The PHACO time (PT) and the average power (AP) were recorded, then absolute PHACO time (APT = PT x AP) was calculated. The differences in PT, AP, APT and BCVA between these two groups were compared. Visual acuity, anterior chamber flare value, thickened pachymetry and endothelial cells loss were recorded 1 day and 3 months after surgery. In addition, surgically induced astigmatism was analyzed. The mean PT, AP and APT of MICS group were significantly lower than those in the SICS group (0.76 +/- 0.36) min versus (0.87 +/- 0.49) min, 10.93% +/- 4.78% versus 16.09% +/- 7.38% and (8.99 +/- 7.23) min versus (15.27 + 12.10) min, respectively (P < 0.01). At 3 months, the vertical astigmatic changes of MICS group was statistically lower than that of the SICS group [(0.37 - 0.32) D versus (1.28 +/- 0.77) D, P = 0.000]. There were no significant differences in the visual acuity, anterior chamber flare value, endothelial cells loss and the thickened pachymetry at 1 day and 3 months after surgery between these two groups (P > 0.05). Bimanual microincision cataract surgery could significantly reduce PHACO power, enhance energy efficiency and reduce surgically induced astigmatism. However, MICS does not reduce surgical trauma and postoperative inflammation as compared to conventional SICS.