Incision integrity and postoperative outcomes after microcoaxial phacoemulsification performed using 2...

Area of Science:

• Ophthalmology
• Surgical Technology

Background:

• Cataract surgery relies on effective incision closure.
• Microcoaxial phacoemulsification systems utilize varying incision sizes.
• Maintaining clear corneal incision (CCI) integrity is crucial for surgical outcomes.

Purpose of the Study:

• To compare incision integrity and clinical outcomes between two microcoaxial phacoemulsification systems.
• Evaluate the impact of different clear corneal incision (CCI) sizes on surgical outcomes.
• Assess postoperative complications related to incision integrity in cataract surgery.

Main Methods:

• Prospective randomized clinical trial comparing a 1.8 mm (Stellaris) and a 2.2 mm (Intrepid Infiniti) microcoaxial phacoemulsification system.
• Measured incision enlargement and trypan blue ingress into the anterior chamber post-surgery.
• Utilized anterior segment optical coherence tomography (AS-OCT) to assess incision integrity, alongside evaluations of corneal thickness, inflammation, endothelial cell loss, and astigmatism.

Main Results:

• The 1.8 mm CCI system showed significantly greater incision enlargement and trypan blue ingress than the 2.2 mm system.
• Anterior segment optical coherence tomography (AS-OCT) revealed more frequent endothelial misalignment and gaping in the 1.8 mm incision group.
• No significant differences were observed in surgically induced astigmatism, central corneal thickness change, endothelial cell loss, or anterior segment inflammation between the groups.

Conclusions:

• Incision integrity is influenced by factors beyond initial size, including intraoperative distortion.
• The 2.2 mm microcoaxial phacoemulsification system demonstrated superior clear corneal incision (CCI) integrity compared to the 1.8 mm system.
• Careful consideration of incision dynamics during phacoemulsification is essential for optimal cataract surgery outcomes.