Corneal incision quality: microincision cataract surgery versus microcoaxial phacoemulsification

Abstract

Purpose: To use corneal optical coherence tomography (OCT) to evaluate the corneal incision quality in microincision cataract surgery (MICS) and microcoaxial phacoemulsification (microphaco).

Setting: Vissum-Instituto Oftalmológico de Alicante, Alicante, Spain.

Methods: Eyes with cataract grade II to IV were randomized into 2 groups for MICS or microphaco. Corneal incision quality was analyzed using corneal OCT on the first postoperative day, week, and month using a purpose-developed protocol and an objective model. Corneal OCT parameters were incision and corneal thickness, incision angle, epithelial and endothelial sealing, incision coaptation, and Descemet detachment. Visual, refractive, corneal topography, and aberrometric data were analyzed.

Results: There were no statistically significant between-group differences in corneal thickness and incision angle quality, geometrically assessed using corneal OCT. Corneal edema was less with MICS than with microphaco (44% versus 87%) (P=.002), as was corneal thickness in the 5.0 to 7.0 mm area (659.9 +/- 56.7 microm versus 697 +/- 80.6 microm) (P=.06), but only at 1 day. At 1 month, prolateness for an 8.0 mm area was maintained in the MICS group. Corneal root-mean-square astigmatism and residual were slightly better with MICS (0.6 +/- 0.4 microm versus 0.9 +/- 0.6 microm, P=.06; 0.6 +/- 0.2 microm versus 0.7 +/- 0.3 microm, P=.05). Other OCT outcome parameters did not differ significantly between groups.

Conclusions: Microincision cataract surgery and microphaco provided similarly good incision quality and optically neutral incisions; the MICS incision respected corneal prolateness more, with less corneal edema in the short term and less induced corneal aberrations in the long term.