Clinical Study
Eye (2007) 21, 807–811; doi:10.1038/sj.eye.6702356; published online 5 May 2006
Feasibility of bimanual microincision phacoemulsification in hard cataracts
None of the authors has a financial or proprietary interest in any of the products mentioned
A Assaf1 and A M El-Moatassem Kotb1
1Department of Ophthalmology, Ain-Shams University, Nasr City, Cairo, Egypt
Correspondence: AM El-Moatassem Kotb, Department of Ophthalmology, Ain-Shams University, 46 Dr Ahmed Mohamed Ibrahim St., Nasr City, Cairo 11471, Egypt. Tel: +202 287 3098; Fax: +202 287 3498; E-mail: ahmedelmotasem@yahoo.com
Received 5 July 2005; Revised 13 March 2006; Accepted 13 March 2006; Published online 5 May 2006.
Abstract
Purpose
The purpose of this work was to assess the feasibility of bimanual phacoemulsification in hard cataracts of N3+ using WhiteStar technology of Soveriegn (Advanced Medical Optics, Santa Ana, CA, USA).
Setting
Ain-Shams University Hospitals, Ophthalmology Department, Cairo, Egypt.
Design
A randomized prospective noncomparative study.
Methods
A randomized prospective study of 33 consecutive cases (N3+ or more) was conducted, phacoemulsification using a bimanual microincision technique using the Sovereign with WhiteStar technology phacoemulsification machine. One phaco mode was used in all eyes. The ultrasound power was set at 30–25% according to the hardness of the nuclei, duty cycle of 33%, flow rate of 20–28 cm3/min, and vacuum of 240 mmHg. Occlusion mode was on. Nine eyes received rollable intraocular lenses (IOL) of ThinOptx, whereas 24 eyes had been implanted with hydrophobic acrylic foldable IOL (Sensar OptiEdge SA40e of AMO) through a third incision. Study parameters were effective phacotime (EPT), presence of wound burn, degree of immediate postoperative iritis, amount of infusion solution used, and total operating time.
Results
The mean EPT was 4.3 s with an average ultrasound used of 5.7%. The mean operating time was 11 min and 20 s. Although the nuclear hardness was of grade 3 or above (in a scale of 5), there were no cases of thermal burn; P=0.005. Only three eyes suffered postoperative iritis 2+, which resolved within 1 week on topical steroids, statistically nonsignificant, P=0.2. The amount of infusion solution was less than that used in conventional coaxial phaco. This technique induced considerably less corneal astigmatism than surgery using conventional corneal incisions.
Conclusions
Hard cataracts of N3 or more could be safely removed through an incision of 1.4 mm incision using bimanual micro-phaco.
Keywords:
bimanual phacoemulsification, microincision phacoemulsification, hard cataracts, rollable IOL, effective phacotime (EPT), MICS
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