Optical coherence tomography of macular thickness after biaxial vs coaxial microincision clear corneal cataract surgery

PURPOSE. To evaluate macular thickness changes after biaxial microincision versus coaxial small incision cataract surgery using optical coherence tomography (OCT). METHODS. This prospective, randomized, marked study comprised 70 patients (70 eyes) undergoing biaxial microincision surgery or conventional coaxial phacoemulsification. Patients were evaluated by Stratus OCT preoperatively and 1 day, 4 weeks, and 8 weeks postoperatively. Best-corrected visual acuity (BCVA), phacoemulsification power, and effective phacoemulsification time (EPT) were evaluated. RESULTS. In the biaxial group, median foveal thickness changed from 160 mu m preoperatively to 168 mu m 8 weeks postoperatively (p=0.018), while median macular volume increased from 2.43 mm(3) to 2.57 mm(3) (p<0.001). In the coaxial group, median foveal thickness increased from 164 mu m preoperatively to 170 mu m 8 weeks postoperatively (p=0.082), while median macular volume changed from 2.45 mm(3) to 2.55 mm(3) (p<0.001). No significant differences in the intraindividual increase of foveal thickness and macular volume were found between groups at 8 weeks. A statistically significant difference between groups was found in median foveal thickness at day 1 postoperatively (p=0.027). No significant differences between groups in median macular volume were found at day 1 or at 4 and 8 weeks postoperatively. Median phacoemulsification power was 7.1% and EPT 2.4 seconds in the biaxial group versus 10.6% and 3.2 seconds in the coaxial group (p<0.001 and p=0.078). CONCLUSIONS. No clinically relevant differences in foveal thickness or macular volume were observed after biaxial microincision and coaxial small incision clear corneal cataract surgery. The blood-retinal barrier did not seem to be influenced by either procedure. (Eur J Ophthalmol 2009; 19: 990-7)