Outcomes of bimanual microincision cataract surgery and 2.2-mm coaxial phacoemulsification

Abstract

Purpose To compare the efficacy and safety outcomes of bimanual microincision cataract surgery (B-MICS) versus 2.2-mm coaxial phacoemulsification (C-MICS). Patients and methods This prospective, interventional, randomized, comparative clinical study was carried out on 60 cataractous eyes. Thirty patients were managed surgically by C-MICS through a 2.2 mm mean incision and 30 patients were managed surgically by B-MICS through a 1.2–1.4 mm trapezoidal incision. The main outcomes measures were postoperative best-corrected distant visual acuity, postoperative spherical equivalent, higher-order aberrations, corneal thickness, corneal endothelial cell loss (ECL), and complications during and after surgery. Both groups were compared for all variables preoperatively. Results The visual rehabilitation in group B was faster than that in group A (nonsignificant). There were nonstatistically significant differences, in the best-corrected visual acuity, between both groups throughout the postoperative period. The mean ECL was statistically significantly higher in group A (221.2±44.1) compared with group B (167.5±67.9) (P<0.001). The mean central corneal thickness change was significantly greater in group A than group B (P=0.01). The surgically induced astigmatism was statistically significantly improved in B-MICS (group B) than C-MICS (group A) (P=0.001). For the other corneal aberrations, there were nonsignificant differences between the two groups. No differences were found in the complications during surgeries between the two groups of cataract surgery. Conclusion The two techniques are reliable, functional, effective, and yield good visual outcomes and low complication rates. B-MICS with the smallest incision induces less astigmatism (surgically induced astigmatism), less ECL, fewer central corneal thickness changes, and enables earlier visual rehabilitation