Objective To compare the outcomes of 1.8 mm coaxial microincision phacoemulsification-trabeculectomy with ultra-thin IOL implants compared to 3.0 mm small incision phacoemulsification-trabeculectomy with foldable IOL implantion. Methods In a prospective controlled study, 68 cases of glaucoma and cataract were selected at the Inner Mongolia Autonomous Region People′s Hospital between October 2011 and October 2013. All patients were randomly divided into two groups. In the small incision group, 34 patients underwent 3.0 mm coaxial microincision phacoemulsification-trabeculectomy with foldable IOL implantation; for the microincision group, 34 patients underwent 1.8 mm small incision phacoemulsification-trabeculectomy with ultra-thin IOL implantation. All cases were followed up at 1 week, 1 month and 3 months. Visual acuity, corneal endothelial cell density, surgically induced astigmatism, intraocular pressure, filtering bleb and complications were evaluated. A t-test, repeat measured ANOVA and Pearson′s chi-square test were used to determine statistical differences between the two samples. Results At 1 week postoperatively, visual acuity tended to be better in the microincision group and the difference was significant (χ2=7.114, P<0.05). At 1 month and 3 months postoperatively, the difference in corrected visual acuity between the 2 groups was statistically significant (χ2=8.053, 10.532, P<0.05). At 1 week postoperatively, there was a significant difference in corneal endothelial cell density between the 2 groups (t=10.254, P<0.05). This was also true at 1 and 3 months (t=7.291, 9.334, P<0.05). At 1 week, 1 month and 3 months postoperatively, there was a significant difference in surgically induced astigmatism between the 2 groups (t=9.112, 10.732, 16.014, P<0.05). IOP decreased after surgery (F=55.934, 69.063, P<0.01) but there was no significant difference between the 2 groups. There was also no significant difference in blebs between the 2 groups (χ2=0.031, P>0.05). No iris injury, posterior capsule rupture or anterior chamber bleeding was foun
Kohnen T. Corneal shape changes and astigmatic aspects of scleral and corneal tunnel incisions[J]. J Cataract Refract Surg, 1997,23:301-302.
[4]
Storr-Paulsen A, Madsen H, Perriard A. Possible factors modifying the surgically induced astigmatism in cataract surgery[J]. Acta Ophthalmol Scand,1999,77:548-551.
Merula RV, Cronemberger S, Diniz Filho A, et al. New comparative ultrasound biomicroscopic findings between fellow eyes of acute angle closure and gloucomatous eyes with narrow angle[J]. Arq Bras Oftalmol,2008,71:793-798.
[10]
Kiuchi Y, Tsujino C, Nakamura T, et al. Phacoemulsification and trabeculotomy combined with goniosynechialysis for uncontrollable chronic angle closure glaucoma[J]. Ophthalmic Surg Lasers Imaging,2010,41:348-354.
Berdahl JP, DeStafeno JJ, Kim T. Corneal wound architecture and integrity after phacoemulsification: evaluation of coaxial,microincision coaxial,and microincision bimanual techniques[J]. J Cataract Refract Surg,2007,33:510-515.
[13]
Hayashi K, Yoshida M, Hayashi H. Postoperative corneal shape changes: microincision versus small-incision coaxial cataract surgery[J]. J Cataract Refract Surg,2009,35:233-239.
[14]
Elkady B, Piero D, Alió JL. Corneal incision quality: microincision cataract surgery versus microcoaxial phacoemulsification[J]. J Cataract Refract Surg,2009,35:466-474.