Bimanual just as safe as coaxial surgery

Removing cataracts using a bimanual microincision technique and implanting a traditional foldable intraocular lens (IOL) through a separate incision causes no more corneal astigmatism compared with a traditional coaxial technique using the same lens, according to a Finnish study.

Kari Krootila and co-workers from Helsinki University Eye Hospital, Finland conducted a randomized study to compare astigmatic changes in bimanual microphacoemulsification compared with coaxial phaco.

In the bimanual microincision group (18 eyes), the cataract was removed through two temporal 1.4 mm incisions. For the IOL implantation, a separate limbal 3 mm incision was made between the two microincisions. In the coaxial group (18 eyes), the cataract was removed using the traditional coaxial technique through a 3 mm temporal limbal incision and one triangular side port incision.

Surgically induced astigmatism (SIA) was 0.89±1.03 D at one day postoperatively and 0.21±0.11 D three months postoperatively in the bimanual group. In the coaxial group, SIA was 0.99±0.89 D at day one and 0.59±0.51 D at three months.

It was concluded that there is little difference in the amount of surgically induced astigmatism between bimanual and coaxial approaches.