Abstract

SA.15.04

Biaxial microincision or coaxial phacoemulsification in complicated cataract: Which technique is better?

Kurz S.¹, Krummenauer F.², Dick H. B.^3
1University of Mainz, Department of Ophthalmology, Mainz; ²Clinical Epidemiology und Health Economy Unit, Dresden; ³Ruhr University, Department of Ophthalmology, Bochum

Objective: To compare the results of biaxial microincision and coaxial small incision in patients with cataract and exfoliation syndrome, uveitis, anterior or posterior synchechia, phacodonesis, or previous intraocular surgery in an 8 weeks follow-up.
Methods: 94 eyes of 94 patients with cataract were included into this prospective randomized study. The eyes were prospectively assigned (1:1) to undergo biaxial microincision (<1,5 mm) phacoemulsification or conventional (2,8 mm) coaxial small incision phacoemulsification using pulsed ultrasound energy (WhiteStar technology, Souvereign^®, AMO, Santa Ana, Ca, USA) with variable duty cycles followed by microincision intraocular lens implantation. Intra- and postoperative complications, best corrected visual acuity (BCVA), laser flare photometry values, effective phacoemulsification time (EPT), mean phacoemulsification power and endothelial cell count were evaluated.
Results: For intra- and postoperative complications, no statistically significant differences were found between both techniques. Corneal edema surrounding the incision was found most frequently (40% in the biaxial versus 35% in the coaxial group), followed by pupillary unrounding (3 versus 7%) and fibrine reaction (3 versus 3%). No other complications were found. In the biaxial group EPT was statistically significantly lower than in the coaxial group (median 1.34 versus 5.4 seconds, p<0,001), as well as the mean phacoemulsification power (3.3 versus 12.9%, p<0,001). No differences between techniques were found in BCVA, laserflare photometry values, as well as endothelium cell count.
Conclusions: Biaxial phacoemulsification needed a shorter EPT and mean phacoemulsification power than coaxial phacoemulsification. These results can be explained by a better grooving of the phacoemulsification handpiece into the nucleus with the biaxial technique. For intra- or postoperative complications, no technique was superior to the other.

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