Bimanual Microincision Cataract Surgery Using a 0.7 mm Sub-millimeter Incision

A bstract Background: Small incisions for cataract surgery are associated with advantages of wound stability, improved control, reduced chamber turbulence, and early visual rehabilitation. However, true sub-millimeter incision cataract surgery is seldom used in clinical practice due to surgical challenges and concerns of visual results. Purpose: To study the visual and surgical results of microincision cataract surgery using a modified bimanual technique using 25-G instruments through a sub-millimeter 0.7 mm incision. Design: Observational case series. Materials and Methods: Fifteen patients underwent cataract surgery using a modified bimanual microincision technique. The technique uses a 25-G phacoemulsification tip with the irrigation sleeve removed. Irrigation was achieved through a separately placed 25-G anterior chamber maintainer. A third 25-G incision was made for introducing the chopper. The nucleus was cracked using two choppers before the phacoemulsification procedure was started. The phacoemulsification was performed in the pulse mode. Results: There were no intraoperative complications, and the anterior chamber remained stable throughout the procedure in all patients. The mean effective phaco time was 2.24 s. Three patients with grade 4 nuclei had transient corneal striate keratopathy that resolved in a week. All patients were followed up for a minimum period of 3 months. Postoperative visual acuity and the aberration profile were assessed. All patients had a distance visual acuity of 6/12 or better at the last follow-up. Conclusion: The modified microincision cataract surgical technique provides an enhanced quality and safety of cataract surgery using a sub-millimeter incision of 0.7 mm.