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

ABSTRACT

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.

KEYWORDS:

• One-handed
• phacoemulsification
• corneal volume
• central corneal thickness
• corneal endothelial cell
• surgically induced astigmatism

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Jiangsu Province Science and Technology Department of Social Development Major Projects-Key Diseases Standardization Diagnosis and Treatment Projects (BE2016669), Nantong Frontier and Key Technologies of Social Innovation of the People Livelihood Programs (MS22015072)