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Kim, Lee, Park, and Joo: Comparison Between Bimanual Microincisional Cataract Surgery and Conventional Coaxial Phacoemulsification
Original Article

J Korean Ophthalmol Soc 2009;50(4):537-541.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.4.537

Comparison Between Bimanual Microincisional Cataract Surgery and Conventional Coaxial Phacoemulsification

Hyun Kyung Kim, MD, Hyun Soo Lee, MD, Shin Hae Park, MD, Choun-Ki Joo, MD, PhD

Department of Ophthalmology and visual science, Seoul St. Mary's Hospital, Colleage of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Choun-Ki Joo, MD, PhD, Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea #505 Banpo-dong, Seocho-gu, Seoul 137-807, Korea Tel: 82-2-2258-7620, Fax: 82-2-533-3801, E-mail: ckjoo@catholic.ac.kr

Received 4 July 2008       Accepted 4 November 2008

Copyright © 2009 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate corneal endothelial cell changes after conventional coaxial phacoemulsification and bimanual microincision cataract surgery (MICS).

Methods

Forty patients were divided into 2 groups, coaxial phacoemulsification (Group 1, n=20), and MICS (Group 2, n=20). To evaluate corneal endothelial cell changes after coaxial phacoemulsification and bimanual MICS, intraoperative phacoemulsification power and volume of intraoperative irrigation solution (balanced salt solution, BSS®, Alcon, U.S.A) were measured. Central corneal thickness and endothelial cell count were also evaluated, preoperatively and at 1 week, and 2 months postoperatively.

Results

Between the 2 groups, there was no statistically significant difference in intraoperative phacoemulsification power and volume of intraoperative irrigation solution (balanced salt solution, BSS®, Alcon, U.S.A.) (p＞0.05). In addition, there was no statistically significant difference between the 2 groups in endothelial cell count and central corneal thickness (p＞0.05).

Conclusions

When comparing bimanual MICS and conventional coaxial phacoemulsification, bimanual MICS appears to have similar endothelial cell changes. In conclusion, MICS has the same safety as compared to coaxial phacoemulsification.

Keywords: Bimual microincisional cataract surgery (Bimanual MICS), Coaxial phacoemulsification, Endothelial cell count, Irrigation solution volume, Phacopower

References

1. Alio J, Rodriguez-Prats JL, Galal A, Ramzy M. Outcomes of Microincision Cataract versus Coaxial Phacoemulsification. Ophthalmology. 2005; 112:1997–2003.
2. Osher RH. Osher. Microcoaxial phacoemulsification Part 2: Clinical study. J Cataract Refract Surg. 2007; 33:408–12.
3. Kelman CD. Phacoemulsification and aspiration. A new technique of cataract removal. A preliminary report. Am J Ophthalmol. 1967; 64:23–35.
4. Jared Emery, Roger F. Steinert. Extracapsular Cataract Surgery: Indications and Techniques. Roger F. Steinert, editor. Cataract surgery. 2nd ed.Philadelphia: Saunders;2004. v. l. chap. 10.
5. Wiliam J. Fishkind, Thomas F. Neuhann, Roger F. Steinert. The Phaco Machine: The Physical Principles Guiding Its Operation. Roger F. Steinert, editor. Cataract surgery. 2nd ed.Philadelphia: Saunders;2004. v. l. chap. 7.
6. Donnenfeld ED, Olson RJ, Solomon R, et al. Efficacy and wound-temperature gradient of Whitestar phacoemulsification through 1.2 mm incision. J Cataract Refract Surg. 2003; 29:1097–100.
7. Shepherd JR. Induced astigmatism in small incision cataract surgery. J Cataract Refract Surg. 1989; 15:85–8.
crossref
8. Steinert RF, Brint SF, White SM, Find IH. Astigmatism after small incision cataract surgery. A prospective, randomized, multicenter comparison of 4 and 6.5 mm incision. Ophthalmology. 1997; 98:417–23.
9. Lee DH, Kim JH, Kim HJ. Endothelial Cell Damage in Microincision Cataract Surgery and Coaxial Phacoemulsification. J Korean Ophahtlmol Soc. 2007; 48:19–26.
10. Mencucci R, Ponchietti C, Virgili G, et al. Corneal endothelial damage after cataract surgery: Microincision versus standard technique. J Cataract Refract Surg. 2006; 32:1351–4.
crossref
11. Milia E, Verges C, Cipres M. Corneal endothelium evaluation after phacoemulsification with continuous anterior chamber infusion. Cornea. 2005; 24:278–82.
crossref

Table 1.
Patient data
Variables Group 1† Group 2‡ p-value
No. patients 20 20  
No. of eyes 20 20  
Sex (M/F) 8/12 8/12  
Age (year-old)      
   mean 67.11±11.14 61.37±10.11 0.180
   range 45–80 45–80  
Nuclear opacity * 2.10±0.79 2.08±0.86 0.658
Preop. visual acuity (Log MAR)    
   uncorrected 0.621±0.29 0.716±0.29 0.150
Postop. visual acuity (Log MAR)    
   uncorrected 0.257±0.28 0.288±0.28 0.983
   corrected 0.125±0.23 0.122±0.34 0.608

* uclear opacity by LOCS III (Lens Opacities Classification System III); Group I=coaxial phacoemulsification

‡ Group II=bimanual microincision cataract surgery. (by Mann-Whitney U test)

Table 2.
Surgical parameters of Group I and Group II
  Group I* Group II†
Settings    
   Phaco power (%) 0∼20 0∼20
   Bottle height (cm) 105 105
   Vacuum power (mm Hg) 120∼200 120∼200
Phacoemulsification mode Pulse mode (PPS‡ 50. DS§ 50%) Pulse mode (PPS 50‡. DS§ 50%)

* Group I=coaxial phacoemulsification

† Group II=bimanual microincision cataract surgery

‡ Pulses per second

§ Duty cycle.

Table 3.
Intraoperative factors of Group I and Group II
  Group I* Group II† P value
Average ultrasound (%) 7.882±2.74 5.433±3.17 0.106
APT‡ (sec) 33.764±18.72 43.090±28.72 0.105
EPT§ (sec) 2.695±0.21 2.977±0.24 0.842
BSS® П volume (ml) 146.25±76.43 170.416±69.06 0.058

* Group I=coaxial phacoemulsification

† Group II=bimanual microincision cataract surgery

‡ Absolute phaco time

§ Effective phac time

П Balanced salt solution (BSS®, Alcon, U.S.A.). (by Mann-Whitney U test)

Table 4.
Preoperative and postoperative corneal thickness of Group I and Group II
  Preoperative (μm) Postop. corneal thickness (μm)
Post op. 1 week Post op. 2 month
Group I* 539±30.4 569±33.3 557±24.7
Group II† 514±36.3 561±39.2 539±41.3
p-value 0.215 0.305 0.115

* Group I=coaxial phacoemulsification

† Group II=bimanual microincision cataract surgery. (by Mann-Whitney U test)

Table 5.
Preoperative and postoperative endothelial cell density of Group I and Group II (Microincision cataract surgery)
  Preoperative (/mm2) Postop. corneal thickness (/mm2)
Group I* 2680.19±446.85 2300.65±632.14
Group II† 2569.94±390.31 2483.25±369.34
p-value 0.415 0.579

* Group I=coaxial phacoemulsification

† Group II=bimanual microincision cataract surgery. (by Mann-Whitney U test)

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