Porównanie wyników fakoemulsyfikacji współosiowej wykonanej techniką małego cięcia z metodą tradycyjną - doświadczenia własne
Micro-coaxial Versus Standard Coaxial Phacoemulsification - Own Experience
Justyna Izdebska, Martyna Pawluczyk-Dyjecińska, Anna Kamińska, Adam Hapunik, Jerzy Szaflik
Katedra i Klinika Okulistyki II Wydziału Lekarskiego Akademii Medycznej w Warszawie Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie Kierownik: prof. dr hab. n. med. Jerzy Szaflik
Summary: Purpose: To compare
outcomes of micro-coaxial (2.4 mm incision) and standard
coaxial (3.2 mm incision) phacoemulsification through
the temporal clear corneal incision.
Setting: Department of Ophthalmology Medical University of Warsaw, Warsaw, Poland
Material and methods: Prospective randomized consecutive series of 60 eyes of 60 patients with nuclear or corticonuclear cataract of grade 2 to 4 on the Lens Opacities Classification System III, underwent coaxial phacoemulsification through the temporal clear corneal incision (2.4 mm or 3.2 mm) with foldable lens implantation (single surgeon). Patients were assigned randomly (1:1) to small incision 2.4 mm Group 1 (30 eyes) or standard incision 3.2 mm Group 2 (30 eyes). Best corrected visual acuity (BCVA), corneal topography, endothelial cell count, anterior chamber inflammatory reaction and possible complications were evaluated preoperatively and at Day 1, Week 1 and Month 1 after surgery.
Results: Statistically significant differences were found between groups regarding surgically induced astigmatism (P<0.001). Mean surgically induced astigmatism was 0.103 ± 0.072 D in the small incision group and 0.600 ± 0.548 D in the standard phacoemulsification group. There were no significant differences between groups regarding the mean percent of endothelial cell loss. There was no difference in the final postoperative visual acuity between groups. We observed less intensive inflammatory reaction after the surgery among patients who underwent small incision surgery.
Conclusions: Small incision cataract surgery trough 2.4 mm results in better wound stability and significantly lowered surgically induced astigmatism when compared with standard coaxial phacoemulsification trough 3.2 mm incision. Less intensive postoperative inflammatory reaction in small incision group may arise from greater wound tightness. Small incision technique causes less corneal trauma around the wound because there is no need to make it tight.
Keywords: small incision surgery, coaxial phacoemulsification, surgically induced astigmatism, clear corneal temporal incision.