Aim: To compare the optical outcomes of biaxial microincision cataract surgery (B-MICS) versus coaxial small-incision cataract surgery (C-SICS).
Methods: Thirty patients (sixty eyes) with bilateral age-related cataract underwent B-MICS through a 1.7-mm clear corneal incision (CCI) in one eye and C-SICS through a 2.8-mm CCI in the other eye. Every eye was implanted with a micro incision aspheric aberration-free IOL (Akreos MI60 AO, Bausch and Lomb, USA). Preoperative corneal aberrations, and 3-month postoperative corneal and total ocular aberrations were calculated and compared.
Results: 3-month postoperative corneal root mean square (RMS) of 3rd- to 6th-order aberrations (p<0.001), 3rd-order trefoil (p=0.001), trefoil-like (p<0.001), and 3rd order RMS (p<0.001) were lower in B-MICS group than in C-SICS group. Surgically-induced corneal trefoil was reduced in B-MICS eyes (p=0.001). Total ocular high-order RMS (p=0.002), 3rd-trefoil (p<0.001), trefoil-like (p<0.001) and 5th-order RMS (p<0.001) were lower in B-MICS than in C-SICS eyes. Corneal aberrations were positively correlated with ocular ones for RMS of 3rd- to 6th-order aberrations, 3rd-trefoil and spherical-like aberrations. Visual acuity, refraction and corneal astigmatism were not different between both groups.
Conclusion: Compared to conventional surgery, B-MICS could improve optical performances of the pseudophakic eye reducing surgically-induced corneal higher-order aberrations. (195 words)