Outcome of cataract extraction with IOL implantation after coaxial and bimanual phacoemulsification

Abstract

Purpose: To compare the outcome of cataract extraction with IOL implantation after coaxial and bimanual phacoemulsification. Materials and Methods: A prospective study was done to compare the outcome of cataract extraction with IOL implantation after coaxial and bimanual phacoemulsification. The study included 200 patients visiting ophthalmology OPD of Punjab Institute of Medical Sciences who were diagnosed as having cataract and were fit to undergo surgery. Of these 100 patients were randomly assigned to each group. Data analysis included demographics and evaluation of visual acuity (VA) outcome, surgically induced astigmatism, mean phacoemulsification time, effective phacoemulsification time and amount of BSS used. Results: Age and sex distribution was similar in two groups. The mean BCVA in the coaxial and bimanual groups was 0.294 and 0.2903 respectively. The magnitude of surgically induced astigmatism had a mean of 0.845 in the coaxial group and a mean of 0.855 in the bimanual group; hence the difference was not statistically significant. Statistically significant differences were found in mean phacoemulsification time (p = 0.01) which was significantly lower in bimanual phacoemulsification group than the coaxial group. Effective phacoemulsification time (p = 0.022) was significantly lower in bimanual phacoemulsification group (mean = 6.86) than the coaxial group (mean = 12.87). The total surgical time was lower in the bimanual group (mean = 21.94) than the coaxial group (mean= 24.29) and the difference was statistically significant. Conclusion: Both techniques were considered safe and equally effective with regard to cataract surgery with minor differences which did not affect the final outcome and resulted in early post-operative visual rehabilitation with minimal post-operative morbidity, thus leading to increased patient comfort. Keywords: Bimanual, Cataract, Coaxial, Microincision, Phacoemulsification, Surgical time.