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Comparative Analysis of One-Handed and Two-Handed Coaxial Phacoemulsification with 2.4-mm Clear Corneal Incision.

Current Eye Research 2018 October 30
PURPOSE: To compare the efficiency and safety of one-handed and two-handed coaxial phacoemulsification Material and Methods: Patients with cataracts underwent one-handed (one-handed group) or two-handed coaxial phacoemulsification (two-handed group) with a 2.4-mm clear corneal incision. Intraoperative phaco parameters, total surgical time, postoperative visual acuity, surgically induced astigmatism (SIA), corneal volume (CV), central corneal thickness (CCT) and corneal endothelial cell counts/size were compared between the two groups.

RESULTS: Each group comprised 105 eyes. There were no significant differences in the intraoperative phaco parameters and total surgical time between the two groups (all p > 0.05). Visual outcomes were significantly better in the one-handed group than in the two-handed group 1 week postoperatively (all p < 0.05) but not 1 month postoperatively. There was no significant difference in SIA between the two groups 1 week (p = 0.695) or 1 month postoperatively (p = 0.772). CV, CCT and endothelial cell loss were significantly lower in the one-handed group than in the two-handed group 1 week postoperatively (CV: p = 0.004; CCT: p = 0.046; endothelial cell loss: p = 0.021), but the above differences were absent 1 month postoperatively except for endothelial cell loss (endothelial cell loss: p = 0.038).

CONCLUSIONS: Both one-handed and two-handed coaxial phacoemulsification were effective and safe surgical techniques. However, the one-handed technique had the advantages of less trauma to the cornea and better early clinical outcomes than the two-handed technique for cataract patients within nuclear opalescence (NO) 3 grade ≤ 3.

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