Comparison of selected parameters of the anterior segment after bimanual phacoemulsification through 1.4 mm microincision, coaxial phacoemulsification through 1.8 mm microincision and coaxial 2.4 mm small incision cataract surgery

Aim of the study
To evaluate and compare the impact of three phacoemulsification techniques on selected parameters of the anterior segment of the eye.

Material and methods
90 patients who were planned for phacoemulsification, and who fulfilled the inclusion criteria, were selected for the study. Group I consisted of 30 eyes after bimanual 1.4 mm microincision cataract surgery (B-MICS). Group II consisted of 30 eyes after coaxial 1.8 mm microincision cataract surgery (C-MICS). Group III consisted of 30 eyes after coaxial 2.4 mm small incision cataract surgery (C-SICS). Patients were examined preoperatively and 1, 7, 30, and 90 days postoperatively.

Results
No complications were seen. There was no significant difference in anterior chamber depth (ACD), in white-to-white (WTW) distance and central corneal thickness (CCT) between the groups during the follow-up (p > 0.05). One day postoperatively mean CCT increased in all groups, next it decreased and one month after surgery it returned to preoperative values. On the first day, there was a statistically significant increase in temporal corneal thickness (at the main incision) in all groups. Next, it gradually decreased. Three months postoperatively, there was a statistically significant difference in the mean temporal corneal thickness between groups – the highest value was in group I and the lowest in group II. In all groups there was a significant postoperative increase in the iridocorneal angles (ICA) measured temporally and nasally (p < 0.05).

Conclusions
There were no significant differences between the groups in mean BCVA, mean ECD, central corneal thickness (CCT), anterior chamber depth, white-to-white (WTW) distance and nasal iridocorneal angle (ICA). Patients in the B-MICS group had significantly greater corneal thickness in the main incision, in comparison to other groups. One month after surgery, there was a significantly greater mean nasal corneal thickness in the B-MICS group in comparison to the C-MICS group. One month and 3 months postoperatively, there was a statistically smaller mean iridocorneal angle width, measured temporally, in the B-MICS group in comparison to groups operated on with coaxial techniques. Both microincision cataract surgery techniques are as safe as standard small incision phacoemulsification.