Evaluation of the Impact of Corneal Width on Surgically Induced Astigmatism (SIA) and Functional Results After Bimanual 1.4 mm Microincision Cataract Surgery (B-MICS), Coaxial 1.8 mm MICS (C-MICS) and 2.4 mm Small Incision Cataract Surgery (C-SICS).
Condition: Cataract; Corneal Astigmatism; Corneal Incision Contracture
MeSH terms: Contracture; Cataract; Astigmatism; Surgical Wound
Study type: Interventional

Summary: 
      The aim of the study is to compare functional results and complications of 3 methods of
      cataract phacoemulsification: bimanual 1.4 mm cataract surgery (B-MICS), coaxial 1.8 mm
      cataract surgery (C-MICS) and coaxial 2.4 mm small incision cataract surgery.
    

Detailed description: 
      Reduction of the width of the corneal incision was one the main changes taking place in
      cataract surgery in recent years. The common use of foldable intraocular lenses (IOLs) and
      technological development of phaco machines allowed to reduce clear corneal incision below 3
      mm. Term of Microincision Cataract Surgery (MICS) understood as cataract phacoemulsification
      performed with the incision width below 2 mm was defined by professor Alio in 2003. However,
      despite various modifications introduced in recent years, phacoemulsification still causes
      damage of the tissues that results in surgically induced astigmatism.

      Two MICS techniques have been developed: bimanual microincision cataract surgery (B-MICS) and
      coaxial microincision cataract surgery (C-MICS).

      In the bimanual technique cataract phacoemulsification can be performed through the main
      incision 1.4 mm wide due to the usage of sleeveless phaco tip (without irrigation) and
      irrigation chopper. The advantage of separation the irrigation from aspiration is improvement
      of liquid dynamics in the anterior chamber. Moreover, due to the usage of the irrigation
      chopper, in B-MICS it is possible to lower the mean ultrasound energy.

      In coaxial technique MICS phacoemulsification is performed through the incision 1.8 mm wide
      with usage of phaco tip with a silicon irrigation sleeve.

      The aim of the study is to compare functional results and complications of 3 methods of
      cataract phacoemulsification: bimanual 1.4 mm cataract surgery (B-MICS), coaxial 1.8 mm
      cataract surgery (C-MICS) and coaxial 2.4 mm small incision cataract surgery. Moreover, this
      study aimed to evaluate the impact of corneal width on best corrected visual acuity
      (uncorrected and corrected), surgically induced astigmatism, endothelial cell loss,
      intraocular pressure, anterior segment of the eye and central retinal thickness.
    

Intervention name(s): Bimanual 1.4 mm microincision cataract surgery (B-MICS) with IOL implantation in a "wound-assisted" technique. In bimanual MICS group a self-sealing 1.4 mm wide incision was created supratemporally; Coaxial 1.8 mm microincision cataract surgery (C-MICS) with IOL implantation with an injector through the 1.8 mm wide incision created temporally.; Coaxial 2.4 mm small incision cataract surgery (C-SICS) with IOL implantation with an injector through the 2.4 mm wide incision located temporally.
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): microincision cataract surgery (phacoemulsification) with implantation of a foldable, acrylic, hydrophilic IOL Incise® MJ14, Bausch & Lomb; microincision cataract surgery (phacoemulsification) with implantation of a foldable, acrylic, hydrophilic IOL Incise® MJ14, Bausch & Lomb; small incision cataract surgery (phacoemulsification) with implantation of a foldable, acrylic, hydrophilic IOL Incise® MJ14, Bausch & Lomb
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: surgically induced astigmatism; phacoemulsification; bimanual microincision cataract surgery; coaxial microincision cataract surgery; small incision cataract surgery; clear corneal incision