Results of Coaxial Phacoemulsification Through a 1.8-mm Microincision in Hard Cataracts

BACKGROUND AND OBJECTIVE: To assess the results of coaxial phacoemulsification through 1.8-mm coaxial microincision cataract surgery (C-MICS) phacoemulsification with foldable intraocular lens implantation in eyes with hard cataracts in comparison to eyes with soft cataracts. PATIENTS AND METHODS: Group 1 consisted of 40 eyes of 40 patients with hard cataracts (grade ≥ 4, Lens Opacities Classification System III scale) and group 2 consisted of 45 eyes of 45 patients with non-mature cataracts (grade ≤ 2, Lens Opacities Classification System III scale). All surgeries were performed by two experienced surgeons under topical and intracameral anesthesia. Examinations were performed preoperatively and 1 month after the surgery. Examined parameters included distance-corrected visual acuity (DCVA), autorefractometry, keratometry, tonometry, endothelial cell counts, and biomicroscopy of the anterior and posterior segment. Surgically induced astigmatism was calculated with vector analysis. RESULTS: Mean DCVA was 0.16 ± 0.16 preoperatively and 0.92 ± 0.21 postoperatively in group 1 (P < .05) and 0.62 ± 0.18 preoperatively and 0.97 ± 0.08 postoperatively in group 2 (P < .05). Mean surgically induced astigmatism was 0.48 ± 0.44 in group 1 and 0.53 ± 0.38 in group 2 (P > .05). Mean endothelial cell loss was 11.37% ± 12.87% in group 1 and 2.87% ± 9.66% in group 2 (P < .05). CONCLUSION: Although density of cataract has an unfavorable influence on early postoperative corneal endothelial cell loss, it did not significantly influence final DCVA and surgically induced astigmatism. C-MICS is a safe and effective method of treatment of cataracts, including cataracts with hard nuclei, and usually leads to good functional outcomes.