Effect of bimanual microincisional cataract surgery versus conventional coaxial small-incision cataract surgery on visual quality: A meta-analysis

Abstract

Objective To evaluate the efficacy of bimanual microincisional cataract surgery (B-MICS) versus conventional coaxial small-incision cataract surgery (C-SICS) for visual quality. Methods A systematic review of B-MICS and C-SICS was conducted by a computer search on Medline, EMCC, OVID, and CNKI and a supplementary manual search was also done. The effect was measured as an odds ratio (OR) and weighted mean difference (WMD). Review manager 4.2 software was used to perform the meta-analysis. A sensitivity analysis was then performed and a publication bias was evaluated by a funnel plot and Egger's regression test. Results Only relevant articles from the resource material were included and/or excluded using a strict criterion. A total of 9 articles were included in the meta-analysis. The ORs of naked visual acuity 0.5 or better at 1 day, 1 week, and 1 month after surgery were 1.82 (95%CI was 1.38-2.39), 2.36 (95%CI was 1.27-4.37) and 1.61 (95% CI was 1.08-2.41), respectively. The differences were statistically significant (P 0.05). A summary WMD of the meta-analysis showed a significant reduction in surgically induced astigmatism in the B-MICS group (WMD =-0.35 D, 95%CI:-0.48- -0.21 D, P<0.01). Sensitivity analysis and publication bias showed that the outcomes of this research were stable and reliable. Conclusion The evidence currently available showed that B-MICS is a safer and more reliable surgery for restoration of visual acuity and reducing surgically induced astigmatism in patients with cataract. Key words: Bimanual microincisional; Phacoemulsification; Visual acuity; Astigmatism; Meta-analysis