J Korean Ophthalmol Soc.  2013 May;54(5):709-715. 10.3341/jkos.2013.54.5.709.

Comparison of Phacodynamic Effects on Postoperative Corneal Edema Between 2.8 mm and 2.2 mm Microcoaxial Torsional Phacoemulsification

• Jeong JH
• Lee HJ
• Lee SH

• KMID: 2217035
• DOI: http://doi.org/10.3341/jkos.2013.54.5.709

Abstract

PURPOSE
To compare the effects of phacodynamic parameters on postoperative corneal edema between 2.8 mm and 2.2 mm microincisional coaxial cataract surgery.
METHODS
A prospective randomized study design was conducted and included 144 cases randomly divided into 2 coaxial cataract surgery groups based on incision size, a 2.8 mm incision (n = 72) or a 2.2 mm microincision (n = 72). The cataract was graded using the lens opacity classification system (LOCS III). The total ultrasound time (TUT), cumulative dispersed energy (CDE), average torsional amplitude (ATA), fluid amount, and case time were measured for each surgery. Central corneal thickness (CCT) was measured preoperatively, and 1 day and 1 month postoperatively. Intraoperative parameters were correlated with postoperative corneal edema.
RESULTS
The average nuclear opacity, intraoperative parameters, and postoperative corneal edema did not differ significantly between the 2 surgical groups. Regression analysis showed corneal edema to be significant in ATA (p = 0.028) in the standard (2.8-mm incision) coaxial group, whereas edema was significantly different with TUT (p = 0.001), CDE (p = 0.001), fluid amount (p = 0.021), and case time (p = 0.027) in the microcoaxial (2.2-mm microincision) group. CCT returned to baseline with an increase of 1.8% at 1 month.
CONCLUSIONS
In the microcoaxial group, sustained ultrasound exposure and prolonged case time caused moderate postoperative corneal edema, while ATA was a significant factor in the standard coaxial group. These data can be used to devise an effective surgical strategy for cataract treatment.

Keyword

Coaxial microincisional cataract surgery; Corneal edema; Phacodynamics

MeSH Terms

Cataract
Corneal Edema
Edema
Phacoemulsification
Prospective Studies

Figure

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  Figure 1. Measurement of central corneal thickness using spectral domain optical coherence tomography (Cirrus; Carl Zeiss Meditec, Dublin, CA) with the anterior module.

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  Figure 2. Comparison of preoperative and intraoperative parameters between the mild and moderate postoperative corneal edema subgroups. Mild corneal edema group means corneal edema at postoperative day 1 ≤ 64 μ m, Moderate corneal edema group means corneal edema at postoperative day 1 >64μ m. * Statistically significant by the Mann-Whitney test.

Reference

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