Abstract
Abstract: :
Purpose:To evaluate the efficacy, safety, wound temperature gradients and endothelial cell loss of The Stortz Millenium (B&L) using burst mode technology in bimanual phacoemulsification Methods: After obtaining fully informed consent 16 patients with visually significant cataract were randomised to have either bimanual microincision (1.2 mm clear corneal incision) without an irrigating sleeve or standard coaxial phacoemulsification (3.2mm clear corneal incision) cataract surgery. Corneal topography, specular microscopy (endothelial cell counts) and visual acuity were measured pre–operatively and at two weeks and three months. Intraoperatively, the following parameters were measured: wound temperature gradients using thermography, effective phaco time (EPT) and average phaco power (AP). Corneal clarity was also recorded postoperatively. Results: Three month data for all patients will be presented. All 16 patients maintained corneal clarity postoperatively with no evidence in either group of thermal damage to the wound either on clinical examination or postoperative corneal topography. There was no statistical difference in endothelial cell loss between the two groups. EPT and AP were reduced in the group undergoing bimanual surgery compared to coaxial phaco. Corneal wound temperatures did not exceed 30º C, well below the temperature required to cause corneal collagen shrinkage. Conclusions: The reduced thermal effects of the Stortz Millenium eliminate the need for an irrigating sleeve during phacoemulsification cataract surgery. This allows safe and effective bimanual cataract surgery through a 1.2 mm incision.
Keywords: small incision cataract surgery • topography • treatment outcomes of cataract surgery