Microcoaxial Phacoemulsification versus Conventional Phacoemulsification: A Prospective Study

Purpose: To compare the outcomes of microcoaxial phacoemulsification and conventional phacoemulsification techniques Methods: In this prospective comparative clinical study in the Negah eye center, 69 eyes of 69 patients with senile cataract of grade 3 to 4 on the Lens Opacities Classification System III (LOCSIII) were placed in two groups. Thirty nine eyes were assigned to undergo surgery by the microcoaxial technique (2.4 mm) and 30 eyes by the conventional coaxial technique (3.2 mm). All surgeries were performed by a single surgeon using the same machine (Sovereign WhiteStar, AMO). In all cases, a temporal clear corneal incision (CCI) was constructed and hydrophobic acrylic flexible intraocular lens (Acrysof Natural, SN60AT) were implanted. Intraoperative parameters including mean phacoemulsification time, total phacoemulsification percentage, effective phacoemulsification time (EPT), total volume of balanced salt solution (BSS) used, and the final size of the corneal incision were measured. Postoperative parameters including uncorrected and best spectacle corrected visual acuity (UCVA, BSCVA), keratometric and astigmatism changes by vector analysis, at 1 day, 5 days and 2 months, were checked. Results: Postoperative BCDVA in 5 days and 2 months in conventional and microcoaxial groups were significantly different. At 5 days, BCDVA was 0.04±0.07 logMAR and 0.00±0.02 logMAR respectively (P=0.006). At 2 months BCDVA was 0.02±0.06 logMAR and 0.00±0.02 logMAR respectively (P=0.044). Mean induced keratometric change in 5 days in conventional and microcoaxial groups were 0.39±0.06 and 0.18±0.24 diopter respectively (P=0.035), but long-term keratometric values showed no significant differences. Other measured intraoperative and postoperative variables showed no significant difference between the two groups. There were no intraoperative or postoperative complications. Conclusion: Microcoaxial phacoemulsification showed significantly less induced keratometric changes and also better corrected visual acuity in early postoperative period. Long-term keratometric values showed no significant differences. Both techniques were effective for surgery in cases with senile uncomplicated cataract.