Clinical Outcomes of Steep-Axis One-Handed Phacoemulsification under the Guidance of a Verion Image-Guided System

Abstract

Purpose. To compare the efficiency and safety of steep-axis one-handed phacoemulsification with steep-axis two-handed phacoemulsification.Patients and Methods. Patients with cataracts underwent steep-axis one-handed (steep-axis one-handed group) or steep-axis two-handed (steep-axis two-handed group) phacoemulsification with a 2.4 mm clear corneal incision (CCI) under the guidance of the Verion Image-Guided System. Intraoperative phacoparameters, such as visual acuity, surgically induced astigmatism (SIA), total corneal astigmatism (TCA), angle of error (AE), corneal volume (CV), and corneal endothelial cells, were compared.Results. There were no significant differences in the intraoperative phacoparameters between the two groups. The visual outcomes were significantly better in the steep-axis one-handed group than in the two-handed group at 1 week postoperatively (allp<0.05) but not at 1 month and 3 months postoperatively. TCAs were significantly decreased in both groups at 1 and 3 months postoperatively (allp<0.05). There were no significant differences at any follow-up points in both groups (allp<0.001). At 3 months postoperatively, the SIA was 0.95 ± 0.44 D in the steep-axis one-handed group and 1.01 ± 0.50 D in the steep-axis two-handed group; there was no significant difference between the groups. The AE was 39.45 ± 26.53° in the steep-axis one-handed group and 49.75° ± 26.23° in the steep-axis two-handed group, which were significantly different (p=0.005). Endothelial cell loss was significantly lower in the steep-axis one-handed group than that in the steep-axis two-handed group at all follow-up points (allp<0.05).Conclusions. Both the steep-axis one-handed and the steep-axis two-handed techniques could significantly decrease TCA. Compared with the steep-axis two-handed technique, the steep-axis one-handed technique has the advantage of decreasing the AE and reducing trauma to the cornea in soft-to-moderate nuclei.