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

Chen, Chong; Zhu, Minjiao; Sun, Yong; Qu, Xinhua; Xu, Xun

doi:10.5301/ejo.5000521

Cited by 13 publications

(8 citation statements)

References 32 publications

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“…For studies reporting visual outcomes not in the logMAR system but rather in the Snellen system: [ 25 ] …”

Section: Methodsmentioning

confidence: 99%

Comparing the Curative Effects between Femtosecond Laser-Assisted Cataract Surgery and Conventional Phacoemulsification Surgery: A Meta-Analysis

Chen

et al. 2016

PLoS ONE

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PurposeTo compare the outcomes of femtosecond laser-assisted cataract surgery (FLACS) with those of conventional phacoemulsification surgery (CPS) for age-related cataracts.MethodsA comprehensive literature search of PubMed, EMBASE, and the Cochrane Controlled Trials Register was conducted to identify randomized controlled trials (RCT) and comparative cohort studies comparing FLACS with CPS. Endothelial cell loss percentage (ECL%), central corneal thickness (CCT), corrected and uncorrected distant visual acuity (CDVA and UDVA), and mean absolute error (MAE) of refraction were used as primary outcomes. Secondary outcomes included surgically induced astigmatism (SIA), mean effective phacoemulsification time (EPT), phacoemulsification power and circularity of the capsulorhexis.ResultsNine RCTs and fifteen cohort studies including 4,903 eyes (2,861 in the FLACS group and 2,072 in the CPS group) were identified. There were significant differences between the two groups in ECL% at one week, about one month and three months postoperatively, in CCT at one day, about one month postoperatively and at the final follow-up, in CDVA at one week postoperatively, and in UDVA at the final follow-up. Significant differences were also observed in MAE, EPT, phacoemulsification power, and the circularity of capsulorhexis. However, no significant differences were observed in CDVA at one week postoperatively or in surgically induced astigmatism.ConclusionsCompared to CPS, FLACS is a safer and more effective method for reducing endothelial cell loss and postoperative central corneal thickening as well as achieving better and faster visual rehabilitation and refractive outcomes. However, there is no difference in final CDVA and surgically induced astigmatism between the two groups.

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“…For studies reporting visual outcomes not in the logMAR system but rather in the Snellen system: [ 25 ] …”

Section: Methodsmentioning

confidence: 99%

Comparing the Curative Effects between Femtosecond Laser-Assisted Cataract Surgery and Conventional Phacoemulsification Surgery: A Meta-Analysis

Chen

et al. 2016

PLoS ONE

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“…When high heterogeneity was detected among the included studies, the random effects model based on the DerSimonian and Laird method was used; otherwise, the fixed-effects model based on the inverse variance method was performed [ 13 ]. For studies reporting BCVA via the Snellen system, the method introduced by Chen et al was used to transfer the data to the logMAR system [ 14 ]. The methods described by Chen et al were utilized to calculate EPT, CDE and ECL% [ 14 – 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…For studies reporting BCVA via the Snellen system, the method introduced by Chen et al was used to transfer the data to the logMAR system [ 14 ]. The methods described by Chen et al were utilized to calculate EPT, CDE and ECL% [ 14 – 16 ]. A sensitivity analysis was used to assess the robustness of the meta-analysis results by sequentially omitting individual studies.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2016

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BackgroundWe conducted this meta-analysis to compare the outcomes of coaxial microincision cataract surgery (C-MICS) and standard coaxial small incision cataract surgery (C-SICS).MethodsThe 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).ResultsA 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).ConclusionsThe 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.

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“…Two published meta-analysis studies have compared the outcomes of B-MICS versus C-SICS and C-MICS versus C-SICS. To our knowledge, there has not been a meta-analysis comparing the outcomes of B-MICS and C-MICS [ 7 , 8 ]. Several clinical studies have compared the intraoperative and postoperative outcomes of B-MICS and C-MICS, but there has been no clear conclusion.…”

Section: Introductionmentioning

confidence: 99%

Bimanual Microincision Cataract Surgery versus Coaxial Microincision Cataract Surgery: A Meta-Analysis of Randomized Controlled Trials and Cohort Studies

Chu

et al. 2017

Journal of Ophthalmology

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Purpose This meta-analysis was conducted to compare the intraoperative and postoperative outcomes of bimanual microincision cataract surgery (B-MICS) and coaxial microincision cataract surgery (C-MICS). Methods Three databases were searched for papers that compared B-MICS and C-MICS from inception to June 2016. The following intraoperative and postoperative outcomes were included in the final meta-analysis: ultrasound time (UST), effective phacoemulsification time (EPT), balanced salt solution use (BSS use), mean surgery time, best-corrected visual acuity (BCVA), central corneal thickness (CCT), and increased CCT. Results There were no statistically significant differences in mean surgery time, UST, BSS use, BCVA, CCT, or increased CCT (one subgroup at postoperative day 7-8 and another subgroup at postoperative day 30). However, there was less EPT needed during surgery (p < 0.01) and lower levels of increased CCT at postoperative day 1 (p = 0.02) in the B-MICS group compared with the C-MICS group. Conclusions The EPT was shorter and increased CCT was less at postoperative day 1 in the B-MICS group. There were no statistically significant differences in other intraoperative and postoperative outcomes between the B-MICS group and the C-MICS group. B-MICS is an efficient and safe cataract surgery procedure.

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

Abstract: The meta-analysis shows that the 2 techniques have similar outcomes in terms of final visual acuity and complications. Bimanual MICS has the advantage of less SIA and phaco time whereas C-SICS has the advantage of quicker surgery and less likelihood of early-onset corneal edema.

Cited by 13 publications

References 32 publications

Comparing the Curative Effects between Femtosecond Laser-Assisted Cataract Surgery and Conventional Phacoemulsification Surgery: A Meta-Analysis

Comparing the Curative Effects between Femtosecond Laser-Assisted Cataract Surgery and Conventional Phacoemulsification Surgery: A Meta-Analysis

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

Bimanual Microincision Cataract Surgery versus Coaxial Microincision Cataract Surgery: A Meta-Analysis of Randomized Controlled Trials and Cohort Studies

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