Clinical Study Of Fusion Phaco Complex Phacoemulsification Through Coaxial 2.2 Mm Microincision

Objective:To compare the clinical outcomes of coaxial 2.2mm microincision Fusion Phaco complex phacoemulsifiation with the standard 3.0mm small incision phacoemulsification.Methods:A randomized prospective study was conducted in the eye center of second hospital affiliated to Zhejiang university during August 2014 to December 2014,99 eyes of 81 patients were enrolled and randomly divided into two groups:microincision cataract surgery(MICS group) with 51 eyes underwent coaxial 2.2mm microincision Fusion Phaco complex phacoemulsification, and small-incision cataract surgery(SICS group) with 48 eyes underwent traditional 3.0mm incision phacoemulsification. Follow-up exams were performed on 1 day,l week,1 month and 3 months after surgery, and collected the average phaco power (AVG), effective phaco time (EPT) and the complications during the operations. Postoperative uncorrected visual acuity, intraocular pressure, optical coherence tomography, astigmatism changes, endothelial cell count were compared between the two groups. Statistical analysis was done with t test and X2 test.Results:There was no statistically significant difference between the two groups on the EPT (t=-0.114, P=0.910), but the AVE in the MICS group was significant lower the SICS group(t=-3.701, P=0.000); There was no statistically significant difference between the two groups on uncorrected visual acuity of one day, one week, one month and three months after the surgery (t=1.087, P=0.280; t=-0.274, P=0.785; t=-0.118, P=0.906; t=0.618, P=0.538). One week, one month and three months after the surgery, the endothelial cell count were better in the MICS group (2265.67±401.96, 2248.37±442.90,2330.98±405.76)/mm2 than in the SICS group (2172.44±551.27, 2174.50±555.07,2258.33±493.11) /mm2, but the difference were no statistically significant (t=0.957,0.734,0.802; P=0.341,0.465,0.424).One week, one month and three months after the surgery, the surgically induced astigmatism(SIA) in the MICS group were (0.46±0.32) D, (0.40±0.40)D, (0.35±0.30) D, less than the in the SICS group (0.95±0.65) D, (0.71±0.46)D, (0.54±0.46) D, and the difference were statistically significant(t=-4.696,-3.579,-2.382; P=0.000,0.001,0.020).There were no statistically significant on the macular retinal thickness between the two groups after the surgery(P=0.413,0.372,0.659).There were no statistically significant on the cornea thickness between the two groups of one day, one week, one month and three months after the surgery (t=0.179,1.221,0.578,0.608; P=0.858,0.225,0.564, 0.545)Conclusion:Compared with the traditional 3.0mm incision phacoemulsification, there was no statistically significant difference between the two groups on the EPT and the endothelial cell count, but the AVE in the MICS group was significant lower the SICS group. Coaxial 2.2mm microincision Fusion Phaco complex phacoemulsification could significantly reduce the surgically induced astigmatism, obtain a better visual acuity.