Purpose: To compare clinical outcomes of biaxial microincision cataract surgery (MICS) with conventional coaxial cataract surgery.
Methods: A comprehensive literature search of Cochrane Library, PubMed and EMBASE to identify relevant prospective randomized controlled trials (RCTs) comparing biaxial MCIS and conventional coaxial phacoemulsification. A meta-analysis was performed on the follow outcome measures: effective phacoemulsification time (EPT), phacoemulsification power (%), corrected distance visual acuity (CDVA), surgically induced astigmatism (SIA), laser flare photometry value, percentage of endothelial cell loss, change in central corneal thickness (CCT), and complications. RevMan 5.0 software was used for data analysis.
Results: Eleven RCTs describing a total of 1064 eyes (542 assigned to biaxial group and 522 to coaxial group) were identified. The quality of the 11 studies was fairly good. There were no significant differences between the techniques regarding the CDVA (P = .45), mean percent of endothelial cell loss (P = .77), laser flare photometry value (P = .59), change in CCT (P = .12), intraoperative or postoperative complications (P = .78 and P = .96, respectively). However, EPT was statistically significant shorter (P = .0008) and the mean phaco power was statistically significant lower (P = .005) in the biaxial group, when compared with coaxial group. Moreover, biaxial MICS induced less SIA (P = .12).
Conclusions: Meta-analysis showed no clear evidence of a benefit of biaxial MICS over conventional coaxial cataract surgery. However, biaxial MICS, with the smaller incision, induced less SIA and reduced some intraoperative parameters. |
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