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J Cataract Refract Surg. 2010 Jun;36(6):890-7. doi: 10.1016/j.jcrs.2009.12.041.

Factors influencing corneal biomechanical changes after microincision cataract surgery and standard coaxial phacoemulsification.

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Vissum Corporation-Instituto Oftalmologico de Alicante, Division of Ophthalmology, Miguel Hernández University, Departamento de Optica (Piñero), Farmacologia y Anatomia, Universidad de Alicante, Spain.



To determine the factors affecting corneal biomechanics using biomechanical waveform analysis after microincision cataract surgery (MICS) and standard coaxial phacoemulsification with different incision sizes.


Vissum-Instituto Oftalmologico de Alicante, Alicante, Spain.


This prospective nonrandomized study comprised eyes with significant cataract that had MICS (sub-1.8 mm incision) or coaxial phacoemulsification (2.75 mm incision). Corneal hysteresis (CH) and the corneal resistance factor (CRF) were measured by biomechanical waveform analysis (Ocular Response Analyzer) preoperatively, immediately postoperatively, and at 1 month. Results were analyzed and compared between groups.


In the MICS group (n = 30), there was a significant increase in Goldmann-correlated intraocular pressure (IOP) and corneal-compensated IOP, although CH decreased in the immediate postoperative period (P<.05). At 1 month, all parameters in the MICS group returned to normal. The coaxial group (n = 30) had an increase in Goldmann-correlated IOP and corneal-compensated IOP, both of which were higher than normal at 1 month. Backward multiple regression analysis showed significant correlations between CH and preoperative Goldmann-correlated IOP and preoperative CRF (r(2) = 0.631, P<.05); between age, axial length (AL), and preoperative CRF (r(2) = 0.418, P<.05); and between the change in CH and AL, total incision length, and preoperative CH (r(2) = 0.429, P<.05).


Cataract surgery with MICS and coaxial phacoemulsification significantly altered corneal biomechanics. Corneal hysteresis was inversely correlated with Goldmann-correlated IOP; CRF was inversely correlated with age and AL. The MICS technique provided more stable corneal biomechanical properties than standard coaxial phacoemulsification 1 month postoperatively.

[Indexed for MEDLINE]

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