Bimanual microincision versus standard coaxial small-incision cataract surgery: meta-analysis of randomized controlled trials.

Abstract

PURPOSE:

This meta-analysis aimed to evaluate the outcomes of bimanual microincision cataract surgery (B-MICS) through a 1.2- to 1.5-mm incision versus standard coaxial small-incision cataract surgery (C-SICS) through a 2.8- to 3.2-mm incision.

METHODS:

A comprehensive literature search was performed according to the Cochrane Collaboration methodology to identify randomized controlled clinical trials comparing B-MICS with standard C-SICS. Main outcome measures were mean surgical time, mean phacoemulsification power, effective phacoemulsification time, best-corrected visual acuity, surgically induced astigmatism (SIA), mean laser flare photometry values, mean endothelial cell loss, mean increased central corneal thickness, and intraoperative and postoperative complications.

RESULTS:

We identified 14 randomized controlled clinical trials that included 1235 eyes diagnosed with cataracts. No statistically significant differences were detected between the 2 surgical procedures in terms of best-corrected visual acuity (p>0.05), SIA at postoperative 1 month (p = 0.09), laser flare photometry values (p = 0.38), mean endothelial cell loss (p = 0.53), increased central corneal thickness at postoperative 1 month (p = 0.64) or 3 months (p = 0.88), intraoperative complications (p = 0.68), and postoperative complications (p = 0.30); however, statistically significant differences were apparent for mean surgical time (p<0.00001), mean phacoemulsification power (p = 0.008), effective phacoemulsification time (p = 0.0009), SIA at postoperative 3 months (p = 0.02), and increased central corneal thickness at postoperative 1 day (p = 0.04).

CONCLUSIONS:

The meta-analysis shows that the 2 techniques have similar outcomes in terms of final visual acuity and complications. Bimanual MICS has the advantage of less SIA and phaco time whereas C-SICS has the advantage of quicker surgery and less likelihood of early-onset corneal edema.

• Authors: Chong Chen, Minjiao Zhu, Yong Sun, Xinhua Qu, Xun Xu
• Journal: European journal of ophthalmology (Eur J Ophthalmol) 2015 Mar-Apr Vol. 25 Issue 2 Pg. 119-27 ISSN: 1724-6016 [Electronic] United States
• PMID: 25363858 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Aged, 80 and over
• Astigmatism (physiopathology)
• Cataract (complications)
• Female
• Humans
• Intraoperative Complications
• Lens Implantation, Intraocular
• Male
• Microsurgery (methods)
• Middle Aged
• Phacoemulsification (methods)
• Photometry
• Postoperative Complications
• Prospective Studies
• Randomized Controlled Trials as Topic
• Visual Acuity (physiology)