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¹Ankara Atatürk EAH, 2. Göz Kliniği, Ankara, Klinik Şefi, Doç. Dr.
²Ankara Atatürk EAH, 2. Göz Kliniği, Ankara, Başasistan, Op.Dr.
³Ankara Atatürk EAH, 2. Göz Kliniği, Ankara, Asist. Dr. Purpose: To investigate the safety and efficacy of bimanual microincision cataract surgery by comparing with 2.2 mm microcoaxial surgical technique.
Materials and Methods: Thirty-five eyes of 30 patients underwent bimanual microincisional cataract surgery (group I) while 35 eyes of 27 patients had 2.2 mm clear corneal incision microcoaxial phacoemulsification (group II). The appropriateness of the groups was investigated by determining 3 parameters that make the operation easier or harder. Accordingly, preoperative cataract hardness, pupil and capsulorhexis diameters were compared first. As the cataract hardness was determined to be greater in Group II, another group (Group IIb) consisting of 20 eyes of 17 patients compatible with Group I was formed and this group was used in comparisons. Preoperatively, central corneal thickness measurements were obtained besides routine ophthalmic examinations in all patients. Peroperative phaco time (PT), mean phaco time percentage (AP%) (PTP), effective phaco time (EPT), total operation time (TOT), peroperative complications and the last incision widths were recorded. Postoperative controls were performed on the 1^st, 7^th, 30^th and 90^th days. In these controls, visual acuity, pachymetric corneal thickness and contrast sensitivity measurements were obtained. In Group I, intraocular lenses with different properties were used by making incision widths adequate.
Results: The mean age of the patients was 64.9±4.2 in Group I and 67.0±7.0 in Group II (p>0.05) and the average follow-up period was 128.9±25.6 days in Group I and 119.3±22.4 days in Group II (p>0.05). Preoperative visual acuities and corneal thicknesses were similar in the groups (p>0.05). Mean cataract hardness was 1.85±0.8 in Group I, 2.54±0.8 in Group II (p<0.05) and 1.90±0.4 in Group IIb (p>0.05). Parameters recorded during the operation in Group I were mean TOT 16.3±6.9 min, mean PT 0.17±0.0 sec, mean PTP 6.80±2.9%and EPT 6.80±2.9 sec, while the same parameters were 13.1±3.3, 0.23±0.1, 13.05±8.1 and 2.29±2.2 in Group II and 13.1±3.4, 0.17±0.1, 11.3±9.2 and 1.54±1.9 in Group IIb, respectively. Statistical comparisons between Group I and II exhibited significant difference in terms of TOT, PT, PTP and EPT (p<0.05). However, there was no statistically significant difference in comparison of Group I with Group IIb in which cataract hardnesses were concordant (p>0.05). No significant difference was determined between the groups in terms of increase from preoperative values of visual acuity, contrast sensitivity or pachymetric corneal thickness or complications (p>0.05).
Conclusion: Although some problems persist, bimanual microincision cataract surgery remains a secure and promising surgical technique. Keywords : Cataract, Phacoemulsification, Bimanual microincision cataract surgery, Microcoaxial cataract surgery