Learning B-MICS in cataract surgery: results and complications

TITLE: Learning B-MICS in cataract surgery: results and complicationsPURPOSE: To evaluate complications and outcomes of bimanual microphacoemulsification performed by a surgeon in training.SETTING: Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy.METHODS: A prospective study about the first 42 eyes of 38 patients underwent cataract surgery performed by the same surgeon in training, using for the first time bimanual microphacoemulsification thecnique (B-MICS), under expert surgeon supervision. Intra and postoperative complications and intraoperative parameters were recorded. Preoperative and postoperative parameters evaluated were visual acuity, astigmatism, corneal pachymetry and endothelial cell count.RESULTS: Of 42 cataract surgery, there were 5 cases of iris trauma (11,9%), one of which (2,38%) with postoperative iris prolaps, 2 cases of capsular rupture without vitreous loss (4,76%), 2 cases of posterior capsular rupture with vitreous loss (4,46%), 1 case of IOL implantation in the sulcus because zonular marked laxity (2,38%), 1 IOL’s loop malposition (2,38%). After surgery visual acuity improved, both at 7 and 30 days (p<0.001). There was also, a statistically significant endothelial cell loss between pre and postoperative phase, reduction that is statistically significant at both 7 that 30 days from the surgery (p <0.001 and p=0.002). There was no statistically significant difference between pre and postoperative astigmatism, and corneal thikness (p>0.05). Instead, there was a statistically significant increase in astigmatism after 7 days in complicated cases (vitreous loss, capsular tear or capsular weakness, p=0,017), in contrast with uncomplicated cases. CONCLUSIONS: Complication rates are similar to that reported in literature about cataract surgery performed by surgeon in training with traditional phacoemulsification technique. B-MICS is a good and safe technique even performed by surgeon in training.