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R.M. Torres, A. Manrique–de–Lara, S. Guillen–Molina, P. Correas; Conventional Phaco versus Microincision Cataract Surgery (MICS) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):636.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate corneal response and anterior chamber inflammation after conventional coaxial phaco or MICS.
Twenty five consecutive patients (fifty eyes) scheduled for routine cataract surgery were selected to perform this prospective clinical study. One eye was operated by conventional phaco (group 1) and the other eye (from the same patient) was operated by MICS (group 2) after special informed consent was accepted. One surgeon performs all the procedures and phacoemulsification time (time during ultrasound energy was applied) and power (percentage of phaco energy) were assessed for each procedure. The following parameters were evaluated preoperatively and at different postoperative time–points to compare both surgical procedures. Cells in the anterior chamber and corneal edema were clinically evaluated at day 0, 1 and 7. Corneal thickness was measured by ultrasound pachymetry at day 0, 7, 30 and 90. Corneal endothelial cells density was measured by non contact specular microscopy at day 0, 1, 7, 30 and 90.
Phacoemulsification time (seconds): group 1: 0.84; group: 0.47. Phacoemulsification power (%): group 1: 21.9; group 2: 12.7. Clinically, anterior chamber inflammation and corneal edema shows no difference between conventional phaco and MICS.
The preoperatively mean central corneal thickness (µm) was 530 (SD 43) in group 1 and 533 (SD 44) in group 2, with no difference 90 days post–surgery (group 1: 532; group 2: 534).
Preoperatively the mean endothelial cell/mm2 count was in group 1: 2458.6 (SD 429.6); group 2: 2347.7 (SD 385.0). Ninety day after surgery the mean endothelial cell/mm2 count was in group 1: 2243.6 (SD 362.7); group 2: 2154.8 (SD 365.7).
Both procedures show loss of corneal endothelial cells (conventional phaco: 8.7% and MICS 8.2%) but without statistical difference.
MICS needs less ultrasound energy and time than conventional phaco, although corneal response and anterior chamber inflammation shows no clinical difference three months after surgery.
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