Wydanie 4/2007
str. 69
Porównanie wyników fakoemulsyfikacji współosiowej wykonanej techniką małego cięcia z metodą tradycyjną - doświadczenia własne
Micro-coaxial Versus Standard Coaxial Phacoemulsification - Own Experience
Justyna Izdebska, Martyna Pawluczyk-Dyjecińska, Anna Kamińska, Adam Hapunik, Jerzy Szaflik
Katedra i Klinika Okulistyki II Wydziału Lekarskiego Akademii Medycznej w Warszawie Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie Kierownik: prof. dr hab. n. med. Jerzy Szaflik
Summary: Purpose: To compare
outcomes of micro-coaxial (2.4 mm incision) and standard
coaxial (3.2 mm incision) phacoemulsification through
the temporal clear corneal incision.
Setting: Department of Ophthalmology Medical
University of Warsaw, Warsaw, Poland
Material and methods: Prospective randomized
consecutive series of 60 eyes of 60 patients with
nuclear or corticonuclear cataract of grade 2 to 4 on
the Lens Opacities Classification System III, underwent
coaxial phacoemulsification through the temporal clear
corneal incision (2.4 mm or 3.2 mm) with foldable lens
implantation (single surgeon). Patients were assigned
randomly (1:1) to small incision 2.4 mm Group 1 (30 eyes)
or standard incision 3.2 mm Group 2 (30 eyes). Best
corrected visual acuity (BCVA), corneal topography,
endothelial cell count, anterior chamber inflammatory
reaction and possible complications were evaluated
preoperatively and at Day 1, Week 1 and Month 1 after
surgery.
Results: Statistically significant differences
were found between groups regarding surgically induced
astigmatism (P<0.001). Mean surgically induced
astigmatism was 0.103 ± 0.072 D in the small incision
group and 0.600 ± 0.548 D in the standard
phacoemulsification group. There were no significant
differences between groups regarding the mean percent of
endothelial cell loss. There was no difference in the
final postoperative visual acuity between groups. We
observed less intensive inflammatory reaction after the
surgery among patients who underwent small incision
surgery.
Conclusions: Small incision cataract surgery
trough 2.4 mm results in better wound stability and
significantly lowered surgically induced astigmatism
when compared with standard coaxial phacoemulsification
trough 3.2 mm incision. Less intensive postoperative
inflammatory reaction in small incision group may arise
from greater wound tightness. Small incision technique
causes less corneal trauma around the wound because
there is no need to make it tight.
Keywords: small incision surgery, coaxial phacoemulsification, surgically induced astigmatism, clear corneal temporal incision.