• Jorge Alió, José Luis Rodríguez-Prats, Ahmed Galal, and Mohamed Ramzy.
• Instituto Oftalmológico de Alicante, VISSUM Corp., and Ophthalmology Division, Miguel Hernandez University, Alicante, Spain. jlalio@vissum.com
• Ophthalmology. 2005 Nov 1; 112 (11): 1997-2003.

PurposeTo compare outcomes of microincision cataract surgery (MICS) with coaxial phacoemulsification.DesignProspective randomized consecutive case series.ParticipantsOne hundred eyes of 50 patients with nuclear or corticonuclear cataract (grades 2+ to 4) with Lens Opacities Classification System III.MethodsOne hundred eyes (50 patients) were randomly operated through clear corneal incisions using 2 techniques: coaxial phacoemulsification (50 eyes) and microincision cataract surgery (50 eyes).Main Outcome MeasuresMean phacoemulsification time, total phacoemulsification percent, effective phacoemulsification time (EPT) (calculated by multiplying total phacoemulsification time in seconds by the average power percent used), intraoperative total balanced salt solution (BSS) volume, visual outcome, vectorial astigmatic changes, corneal thickness, endothelial cell count, and anterior chamber flare and cells preoperatively and at 1 day, 1 month, and 3 months.ResultsStatistically significant differences were found between MICS and coaxial phacoemulsification regarding mean incision size, mean total phacoemulsification percent, and EPT. There were no significant differences between the techniques regarding the mean percent of endothelial cell loss, anterior chamber cell count and flare, mean phacoemulsification time, pachymetric measures or total BSS volume utilized, or visual outcome. The vectorial astigmatic changes in the MICS group showed a change of < or =0.25 diopters (D) in 35% of the eyes, 0.25 to 0.5 D in 50% of the eyes, and 0.5 to 1.0 D in 15% of the eyes. These changes were induced by the surgery. Vectorial astigmatic changes of >1 D were not observed. In the coaxial phacoemulsification group, vectorial astigmatic changes of <0.25 D were not observed either. Changes of 0.25 to 0.5 D were seen in 20% of the eyes, and changes of 0.5 to 1.0 D were seen in 30%. Fifty percent of the eyes showed changes of >1.0 D. Mean vectorial astigmatic changes were 0.36+/-0.23 D in the MICS group and 1.2+/-0.74 D in the coaxial phacoemulsification group (P<0.001).ConclusionsMicroincision cataract surgery significantly lowered mean phacoemulsification time, mean total phacoemulsification percent, mean EPT, and surgically induced astigmatism when compared with coaxial phacoemulsification.

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