J Korean Ophthalmol Soc.  2014 Oct;55(10):1460-1469. 10.3341/jkos.2014.55.10.1460.

Change in Central Macular Thickness after 2.2-mm Microincision Coaxial versus 2.75-mm Small Incision Cataract Surgery

  • 1Department of Ophthalmology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea. eunchol@hanmail.net


To evaluate the central macular thickness and volume changes after conventional 2.75-mm small incision cataract surgery (SICS) and 2.2-mm microincision coaxial cataract surgery (MICS).
We performed a retrospective chart review of 48 eyes undergoing uneventful phacoemulsification and divided the subjects into two groups, SICS and MICS. To evaluate the central macular thickness and volume changes after cataract surgery, optical coherence tomography (OCT) was used before and at one day, one week, one month, and two months postoperatively.
No statistically significant difference was found in the intraoperative phacoemulsification power, phaco time, or volume of intraoperative irrigation solution between the two groups (p > 0.05). The average central macular thickness increased in the MICS group compared to the SICS group at every postoperative time point, and the difference was statistically significant at postoperative one month (p = 0.04). The average central macular volume was elevated in the MICS group; however, the difference was not significant (p > 0.05).
Central macular thickness and volume change were greater in the MICS group compared to the SICS group, and the difference in central macular thickness between the two groups was significant at postoperative one month. Careful follow-up examinations should be performed using OCT at this postoperative time point, especially in patients who received cataract surgery with smaller incision size.


Central macular thickness; Central macular volume; Microincision coaxial cataract surgery; Optical coherence tomography

MeSH Terms

Follow-Up Studies
Retrospective Studies
Tomography, Optical Coherence


  • Figure 1. Central macular thickness and central macular volume change at each postoperative time period (student t-test p < 0.05*). POD = postoperative date.

  • Figure 2. Analysis of central macular thickness and central macular volume change in time course at each postoperative period (repeated measures ANOVA; Central macular thickness; Small incision cataract surgery (SICS) group p = 0.027, microincision coaxial cataract surgery (MICS) group p = 0.012; Central macular volume; SICS group p = 0.048, MICS group p = 0.036). POD = postoperative date.

  • Figure 3. Subset analysis comparing central macular thickness and central macular volume between MICS and SICS group according to cataract grading (nuclear opacity of LOCS III) (student t-test p < 0.05*). POD = postoperative date; NO = nuclear opacity; SICS = small incision cataract surgery; MICS = microincision coaxial cataract surgery; LOCS III = lens opacities classification system III.

  • Figure 4. Correlation analysis of intraoperative factors (ultrasound time, cumulative dissipated energy) and central macular thickness, central macular volume, respectively (r = Pearson correlation coefficient). POD = postoperative date; UST = ultrasound time; CDE = cumulative dissipated energy.

  • Figure 5. The optical coherence tomography (OCT) images of a patient with macular edema at preoperative (A) and postoperative 1 day (B), 1 week (C), 1 month (D), 2 months (E).

  • Figure 6. The FAG images of a patient with macular edema at postoperative 1 month: Arterial phase (A), A-V phase (B), venous phase (C), recirculation phase (D) and late phase (E). FAG = fluorecein angiography; A-V = arterial-venous.



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