[Small incision cataract surgery-silicone intraocular lens vs polymethylmethacrylate intraocular lens]

We compared the postsurgical results of two small incision cataract surgery procedures: silicone intraocular lens implantation through a 3.2 mm incision and polymethylmethacrylate intraocular lens implantation through a 5.5 mm incision. One hundred fifty eyes of 124 patients were randomly assigned to either procedure, and the patients underwent phacoemulsification and intraocular lens implantation without sutures or scleral cautery. Identical surgical techniques were employed in each case except for the size of the incision. Patients in the 3.2 mm incision group showed: (1) better uncorrected and corrected visual acuity in the early postoperative period, (2) lower aqueous flare intensity immediately after surgery, (3) less operatively induced corneal astigmatism throughout the study period up to 3 months after surgery, and (4) less corneal topographic change, i.e., less corneal flattening, 3 months after surgery. There were no significant differences between groups in the corneal endothelial cell loss, blood-aqueous barrier permeability measured by fluorophotometry, or postoperative complications. It was concluded that both procedures offer highly satisfactory clinical results, but that the 3.2 mm incision surgery allows a significantly earlier recovery of visual function and less surgery-induced corneal astigmatism.