Comparative analysis of coaxial phacoemulsification with 2.2- and 2.8-mm clear corneal incisions.

PURPOSE: To compare the intraoperative efficiency and postoperative visual outcome of coaxial phacoemulsification using 2.2- and 2.8-mm clear corneal incision coaxial phacoemulsification. SETTING: The study was conducted at Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi which is a tertiary health care centre. STUDY DESIGN: This is a prospective, randomized, comparative interventional study. MATERIALS AND METHODS: A total of 140 eyes of patients undergoing cataract surgery were enrolled according to the inclusion-exclusion criteria and randomly divided in two groups of 70 such that Group I-Patients underwent phacoemulsification through 2.8-mm clear corneal incision. Group II-Patients underwent phacoemulsification through 2.2-mm clear corneal incision.Postoperative assessment was done at 1 day, 1 and 6 weeks to note best-corrected visual acuity (BCVA), ophthalmic examination, corneal topography, central corneal thickness and corneal endothelial cell count. STATISTICS: 1. Quantitative variables were compared using Mann-Whitney test and Wilcoxon ranked-sum test. 2. Qualitative variables were compared using Fisher's exact test. p value of <0.05 was considered statistically significant. RESULTS: There is steady trend in decrease in postoperative astigmatism with time, more so in 2.8 mm group; however, differences were not found to be statistically significant. 2.2 mm group had larger increase in CCT and ECC compared to 2.8 mm group which was not statistically significant (p = 0.296). CONCLUSION: Reducing the incision size from 2.8 to 2.2 mm does not result in any significant reduction in the amount of surgically induced astigmatism. Also, both the incision sizes have similar intraoperative efficacy when compared in terms of postoperative decrease in corneal endothelial cell count and increase in central corneal thickness.