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B-MICS with incise IOL implantation through 1.4 mm clear corneal incisions

Session Details

Session Title: Cataract II

Session Date/Time: Saturday 15/02/2014 | 08:30-11:00

Paper Time: 08:36

Venue: Gallus Hall (Level -1)

First Author: : GiulioTorlai ITALY

Co Author(s): :    Gian Maria Cavallini   Michele De Maria   Luca Campi        

Abstract Details

Purpose:

To compare the morphological features of 1.4 mm clear corneal incision (CCI) implanted with an INCISE MJ14 IOL vs. 1.5 mm CCIs stressed by the implant of an Akreos MI60 IOL in patients who underwent bimanual microincisions cataract surgery (B-MICS).

Setting:

Institute of Ophthalmology, University of Modena & Reggio Emilia, Modena, Italy (Head: Prof. Gian Maria Cavallini).

Methods:

Prospective study. To compare 30 eyes which underwent B-MICS and implanted with INCISE MJ14 IOL through 1.4 mm CCI (group A) with 30 eyes which underwent B-MICS and implanted with Akreos MI60 IOL through 1.5 mm CCI (group B), between April 2013 – July 2013. All patients have been operated by the same experienced surgeon with the same surgical technique for cataract extraction: two trapezoidal incisions are created in the clear cornea at 10 and 2 o’clock, continuous capsulorhexis is performed with the a cystotome or with the dedicated microforceps, phacoemulsification is performed with a 20-gauge, 30 degree-angled sleveless probe and an irrigating chopper, by stop-and-chop technique, finally the IOL has been implanted through a 1.4 mm incision in group A and through 1.5 incisions in group B. All patients underwent a preoperative and postoperative complete ophthalmological evaluation (corrected distance visual acuity CDVA, endothelial biomicroscopy, slit lamp examination, autorefractometry). All the CCIs have been evaluated through an anterior segment OCT (AS-OCT) and slit lamp camera at 1, 3, 7 and 30 days after surgery. All clinical parameters have been reported and analyzed.

Results:

CDVA at 30 days was 0.93 (±0.19 SD) in group A and 0.94 (±0.17 SD) in group B. Endothelial cell density at 30 days was 2026.99 (±392.35 SD) cells/mm2 group A and 2102.96 (±489.85 SD) cells/mm2 in group B. At slit lamp camera no severe complications has been reported during the follow-up in both the groups. At the AS-OCT the only common evidences in both the groups were endothelial gaping and local detachment of Descemet’s membrane with a progressive reduction in the first week of the follow-up.

Conclusions:

Both techniques appeared to be safe and effective with a rapid visual recovery and a high patients’ satifsfaction. The incisions in both the groups achieve a fast healing since the first week of follow-up and only temporary morphological alterations were detectable through anterior segment imaging. Group A incisions, probably due to a smaller incisions size at the time of implantation, compared to group B incisions which underwent an enlargement to 1.5 mm prior to the IOL implant, presented statistically significant fewer endothelial gaping (p-value 0.04) and local detachment of Descemet’s membrane (p-value 0.03) in the first postoperative days. B-MICS associated with INCISE MJ14 IOL implantation through 1.4 mm incisions is both minimally invasive and the corneal healing is faster, even comparing it to a similar surgical technique in which incisions are slightly larger. FINANCIAL INTEREST: NONE