Development and Comprehensive Assessment of the Clinical Effectiveness of a Method For Cataract Phacoemulsification Based on a Single Tunnel Incision

Abstract

Purpose. Development and evaluation of the clinical effectiveness of a technique for performing phacoemulsification of cataracts (FEC) based on a single tunnel incision.Patients and methods. We observed 96 patients (96 eyes, age 58.2 ± 1.2 years, 61 men, 35 women), divided into two groups equal in age, gender and visual status: control (CG, 46 patients, 46 eyes), for whom FEC was performed using the traditional method (total incision length 4.6 mm) and the main group (MG, 50 patients, 50 eyes), for whom FEC was performed using the developed method (total incision length 2.2 mm). The basis of the developed technique is to make a tunnel incision 2.2 mm long on the temporal side, followed by capsulorhexis, phacofragmentation, phacoemulsification of the lens nucleus and aspiration of the lens masses through a single tunnel incision. In this case, during phacofragmentation, a longitudinal fracture of the lens nucleus is performed along the axis 0–180°, the lens nucleus is rotated along the meridian 90–270° and another longitudinal fracture of the lens nucleus is performed along the axis 0–180°, and after phacoemulsification of the nucleus, aspiration is performed through a coaxial handle and IOL is implanted. A comparative assessment of the clinical effectiveness of the developed and traditional methods was carried out using clinical, refractive, morphological and biochemical parameters.Results. A higher clinical effectiveness of FEC using the developed method has been established (compared to the traditional one), which is confirmed by a decrease in the magnitude of surgically induced astigmatism (by 0.13 diopters, p < 0.001) and a tendency towards higher postoperative uncorrected distance visual acuity (by 0.05 rel. units, p > 0.05). Along with this, in the МG, compared with the CG, a pronounced decrease in the incidence of dry eye syndrome (by 3.4 %, p < 0.05), C­reactive protein in the tear fluid (by 1.1 mg/l, p < 0.05) and preservation of the number of endothelial cells (by 4.8 %, p < 0.01).Conclusion. The developed technique for performing FEC is an effective prevention of surgically induced astigmatism and negative effects on the corneal endothelium and ocular surface, which is associated with a decrease in the total length of the incision (2.2 mm compared to 4.6 mm) and an intraoperative decrease in the total volume of circulating fluid.