3 YEAR PROSPECTIVE, RANDOMIZED EVALUATION OF INTRAOCULAR-LENS IMPLANTATION THROUGH 3.2 AND 5.5 MM INCISIONS

Purpose: To compare the long-term clinical results of two small incisi on cataract surgery procedures. Setting: Seven centers in Japan. Metho ds: Two hundred eyes were randomly assigned to receive a silicone intr aocular lens (IOL) through a 3.2 mm incision or a poly(methyl methacry late) (PMMA) IOL through a 5.5 mm incision. Except for incision size a nd implantation technique, the surgical methods were identical. Uncorr ected and corrected visual acuity, keratometry, flare-cell intensity, specular microscopy, and neodymium:YAG (Nd:YAG) laser posterior capsul otomy rate were analyzed up to 3 years after surgery. Results: Eyes in the 3.2 mm incision group had significantly better uncorrected and co rrected visual acuity in the early postoperative period and lower aque ous flare intensity immediately after surgery, but these differences d isappeared after the first postoperative month. However, surgically in duced astigmatism was significantly less in the 3.2 mm incision group than in the 5.5 incision group throughout the study. The Nd:YAG laser capsulotomy rate was higher in the silicone IOL group (23.5% at 3 year s postoperatively) than in the PMMA IOL group (18.4%), but the differe nce was not statistically significant. Conclusion: Smaller incision ca taract surgery led to earlier recovery of visual function in the short term and less induced astigmatism in the long term.