Coaxial Microincision Cataract Surgery versus Standard Coaxial Small-Incision Cataract Surgery: A Meta-Analysis of Randomized Controlled Trials

PLoS One. 2016 Jan 8;11(1):e0146676. doi: 10.1371/journal.pone.0146676. eCollection 2016.

Abstract

Background: We conducted this meta-analysis to compare the outcomes of coaxial microincision cataract surgery (C-MICS) and standard coaxial small incision cataract surgery (C-SICS).

Methods: The outcomes of randomized controlled trials (RCTs) reporting C-MICS and C-SICS were collected from PubMed, Web of Science, and The Cochrane Library in May 2015. The final meta-analysis was conducted on the following intraoperative and postoperative outcomes: ultrasound time (UST), effective phacoemulsification time (EPT), balanced salt solution use (BSS use), cumulative dissipated energy (CDE), mean surgery time, endothelial cell loss percentage (ECL%), best corrected visual acuity (BCVA), increased central corneal thickness (CCT), laser flare photometry values and surgically induced astigmatism (SIA).

Results: A total of 15 RCTs, involving 1136 eyes, were included in the final meta-analysis. No significant between-group differences were detected in EPT, BSS use, CDE, BCVA, laser flare photometry values or increased CCT. However, the C-MICS group showed less SIA (at postoperative day 7: p<0.01; at postoperative day 30 or more: p<0.01) and greater ECL% (at postoperative day 60 or more: p<0.01), whereas the C-SICS group required a shorter UST (p<0.01).

Conclusions: The present meta-analysis suggested that the C-MICS technique was more advantageous than C-SICS in terms of SIA, but C-MICS required a longer UST and induced a higher ECL%. Further studies should be done to confirm our results.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Astigmatism / etiology
  • Cataract / pathology
  • Cataract / therapy
  • Cataract Extraction / adverse effects
  • Cataract Extraction / methods*
  • Cornea / pathology
  • Corneal Pachymetry
  • Humans
  • Microsurgery
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Grants and funding

This work was supported by Zhejiang KeyLaboratory Fund of China (Grant No. 2011E10006), the National Natural Science Foundation of China (Grant No. 81371000), the Natural Science Foundation of Zhejiang Province (Grant No.LY14H120002), and the Foundation from Health and Family Planning Commission of Zhejiang Province (Grant No. 201347434). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.