Abstract:AIM: To investigate the curative effect of 3.0mm incision phacoemulsification and 1.8mm coaxial micro-incision phacoemulsification and the influence on corneal endothelial cells.
METHODS: A total of 78 patients(78 eyes)with age-related cataract who were hospitalized in the hospital from December 2016 to December 2018 were selected as subjects. They were divided into the standard incision group and the micro-incision group with 39 cases(39 eyes)in each group. Patients in the standard incision group were treated with 3.0mm standard incision phacoemulsification and intraocular lens implantation, while the patients in the micro-incision group were treated with 1.8mm coaxial micro-incision phacoemulsification and intraocular lens implantation. The surgical outcome and corneal endothelial cell parameters were compared between the two groups.
RESULTS: The phacoemulsification time of the standard incision group and the micro-incision group were(7.05±0.98)s and(7.22±0.96)s, respectively. The phacoemulsification energy was(17.01±1.89)% and(16.89±1.53)%, respectively(P>0.05). The LogMAR of naked eyes of both groups decreased significantly at 1d, 1wk and 1mo after surgery(P<0.001), while the degree of astigmatism increased(P<0.001). The naked vision and astigmatism of the micro-incision group were better than those of the standard incision group at 1d and 1wk after surgery(P<0.05). Endothelial cell density was significantly decreased at 1d, 1wk and 1mo after surgery(P<0.05). The coefficient of variation of corneal endothelial cells and the thickness of central cornea increased. There was no significant difference between the standard incision group and the micro-incision group at each time poilt(P>0.05). There were no severe complications in either group. There was one patient with transient high intraocular pressure in the standard incision group, and the intraocular pressure returned to normal after drug treatment.
CONCLUSION: Both coaxial micro-incision phacoemulsification and standard small incision surgery have certain effects on the morphology and function of endothelial cells. Besides, there is no significant difference between them. However, coaxial micro-incision phacoemulsification can minimize the surgical incision and reduce the degree of surgically induced astigmatism, and patients can recover quickly after surgery. It is a relatively safer surgical procedure.