Effective Lens Position According to Incision Width in Cataract Surgery Using Phacoemultification and Posterior Chamber Lens Implantation.

PURPOSE: To compare effective lens position (ELP) after phacoemulsification between micro-incision (2.25 mm) and small-incision (2.75 mm) groups.

METHODS: Sixty-seven eyes with age-related cataracts were randomly divided into two groups based on the width of the corneal incision (micro-incision [n = 33] and small-incision groups [n = 34]). Participants underwent clear corneal incision phacoemulsification combined with intraocular lens implantation. Uncorrected visual acuity, refractive error, corneal astigmatism, and ELP were measured preoperatively and at 2 months postoperatively. ELP was calculated using the Sheimpflug method.

RESULTS: Postoperative mean visual acuity and refractive error did not differ between the groups (logMAR 0.02 vs. logMAR 0.04, P = 0.108; -0.30 diopter [D] vs. + 0.07 D, P = 0.339). The postoperative surgically-induced corneal astigmatism was higher in the small-incision group than it was in the micro-incision group, although the difference did not reach statistical significance (+ 0.01 D vs. -0.36 D, P = 0.063). The mean difference between the pre and postoperative ELP values was significantly higher in the small-incision group than that in the micro-incision group (-0.04 mm vs. -0.51 mm, P = 0.024).

CONCLUSIONS: Although there was no significant difference in postoperative refractive error and corneal astigmatism between the micro- and small-incision phacoemulsification groups, the mean error between pre and postoperative ELP was higher in eyes that underwent phacoemulsification with larger corneal incisions than it was in those that underwent smaller incisions.