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A review of single-handed coaxial phacoemulsification technique for cataract surgery

*Yunani Setyandriana  -  Department of Ophthalmology, Medical Faculty and Health Science, Universitas Muhammadiyah Yogyakarta, Indonesia
Nurul Attikah Zain  -  General Practitioner, Universitas Muhammadiyah Yogyakarta, Indonesia, Indonesia
Open Access Copyright (c) 2024 Diponegoro International Medical Journal
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Abstract

Background: Currently, cataract surgery is categorized into two main techniques: phacoemulsification and femtosecond-laser-assisted-cataract-surgery (FLACS)..

Objective: The objective of this study was to present a comprehensive review of the existing literature on the single-handed coaxial phacoemulsification technique used in cataract surgery.

Methods: The study conducted a systematic review of PubMed, EMBASE, and Scopus databases. The participants included in our study were individuals diagnosed with simple cataract. These individuals had treatment using either single-handed or two-handed phacoemulsification or FLACS techniques. Publications predating the year 2000 were omitted from consideration. The abstracts of the publications were analyzed utilizing the PRISMA diagram, and those deemed to be somewhat and highly pertinent were incorporated. In total, a comprehensive analysis was conducted on six research, consisting of two randomized controlled trials (RCTs) and four non-randomized controlled trials (nonRCTs).

Results: The visual acuity (VA) shown a statistically significant improvement in the single-handed group compared to the two-handed group at the one-week postoperative assessment (p<0.05). However, this difference was not observed at the one-month and three-month postoperative assessments.  The single-handed group had a smaller angle of error (AE) compared to the two-handed group (p=0.005). Additionally, another study observed an improvement in visual acuity (VA) in individuals who underwent single-handed, two-handed group, and femtosecond laser-assisted cataract surgery (FLACS). However, the study did not identify any statistically significant variations in VA improvement across the three groups. There was no statistically significant difference observed among the three groups in relation to ECL and CCT. The intraoperative phacoparameter exhibited a statistically significant decrease in the single-handed group (P<0.01) compared to the two-handed group, while it did not differ substantially from the femtosecond laser-assisted cataract surgery (FLACS) group.

Conclusion: When comparing the two-handed phacoemulsification technique to FLACS, it was observed that a single-handed method exhibited a reduced angle of error, minimized corneal damage, and exhibited early visual outcomes.

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Keywords: Cataract surgery; FLACS; Single-handed phacoemulsification; Two-handed phacoemulsification

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  1. Khokhar S, Surve A, Verma S, et al. Cataract in retinopathy of prematurity – A review. Indian J Ophthalmol 2022; 70: 369
  2. Bali J, Bali O, Sahu A, et al. Health economics and manual small-incision cataract surgery: An illustrative mini review. Indian J Ophthalmol 2022; 70: 3765
  3. Kelman CD. Phaco-emulsification and aspiration. A new technique of cataract removal. A preliminary report. Am J Ophthalmol 1967; 64: 23–35
  4. Dupont-Monod S, Labbé A, Fayol N, et al. In vivo architectural analysis of clear corneal incisions using anterior segment optical coherence tomography. Journal of Cataract and Refractive Surgery 2009; 35: 444–450
  5. Czajka MP, Frajdenberg A, Johansson B. Comparison of 1.8-mm incision versus 2.75-mm incision cataract surgery in combined phacoemulsification and 23-gauge vitrectomy. Acta Ophthalmol 2016; 94: 507–513
  6. Lundström M. Endophthalmitis and incision construction. Current Opinion in Ophthalmology 2006; 17: 68–71
  7. Can İ, Takmaz T, Yıldız Y, et al. Coaxial, microcoaxial, and biaxial microincision cataract surgery: Prospective comparative study. Journal of Cataract and Refractive Surgery 2010; 36: 740–746
  8. Kawahara A, Kurosaka D, Yoshida A. Comparison of surgically induced astigmatism between one-handed and two-handed cataract surgery techniques. OPTH 2013; 1967
  9. Moshirfar M, Hsu M, Churgin D. Femtosecond laser-assisted cataract surgery: A current review. Middle East Afr J Ophthalmol 2011; 18: 285
  10. Soong HK, Malta JB. Femtosecond Lasers in Ophthalmology. American Journal of Ophthalmology 2009; 147: 189-197.e2
  11. Conrad-Hengerer I, Al Juburi M, Schultz T, et al. Corneal endothelial cell loss and corneal thickness in conventional compared with femtosecond laser–assisted cataract surgery: Three-month follow-up. Journal of Cataract and Refractive Surgery 2013; 39: 1307–1313
  12. Chen L, Hu C, Lin X, et al. Clinical outcomes and complications between FLACS and conventional phacoemulsification cataract surgery: a PRISMA-compliant Meta-analysis of 25 randomized controlled trials. Int J Ophthalmol 2021; 14: 1081–1091
  13. Schweitzer C, Brezin A, Cochener B, et al. Femtosecond laser-assisted versus phacoemulsification cataract surgery (FEMCAT): a multicentre participant-masked randomised superiority and cost-effectiveness trial. The Lancet 2020; 395: 212–224
  14. Gigliola S, Niro A, Eye Clinic, Hospital “SS. Annunziata”, ASL Taranto, Taranto 74121, Italy, et al. Comparison of perioperative parameters in one-handed rotational phacoemulsification versus conventional phacoemulsification and femtosecond laser-assisted cataract surgery. Int J Ophthalmol 2021; 14: 1868–1875
  15. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009; 339: b2535–b2535
  16. Day AC, Burr JM, Bennett K, et al. Femtosecond Laser-Assisted Cataract Surgery Versus Phacoemulsification Cataract Surgery (FACT). Ophthalmology 2020; 127: 1012–1019
  17. Dzhaber D, Mustafa OM, Alsaleh F, et al. Visual and refractive outcomes and complications in femtosecond laser-assisted versus conventional phacoemulsification cataract surgery: findings from a randomised, controlled clinical trial. Br J Ophthalmol 2020; bjophthalmol-2019-314548
  18. Chen X, Yu Y, Song X, et al. Clinical outcomes of femtosecond laser–assisted cataract surgery versus conventional phacoemulsification surgery for hard nuclear cataracts. Journal of Cataract and Refractive Surgery 2017; 43: 486–491
  19. Li P, Wu J, Guan Y, et al. Comparative Analysis of One-Handed and Two-Handed Coaxial Phacoemulsification with 2.4-mm Clear Corneal Incision. Current Eye Research 2019; 44: 237–242
  20. Li P, Tu Y, Chen X, et al. Clinical Outcomes of Steep-Axis One-Handed Phacoemulsification under the Guidance of a Verion Image-Guided System. Journal of Ophthalmology 2019; 2019: 1–7
  21. Khokhar S, Lohiya P, Murugiesan V, et al. Corneal astigmatism correction with opposite clear corneal incisions or single clear corneal incision: Comparative analysis. Journal of Cataract and Refractive Surgery 2006; 32: 1432–1437
  22. Nemeth G, Berta A, Szalai E, et al. Analysis of Surgically Induced Astigmatism on the Posterior Surface of the Cornea. J Refract Surg 2014; 30: 604–608
  23. Li P, Zhang Y, Kang L, et al. Comparison of variations in cornea after one-handed and two-handed coaxial phacoemulsification. OPTH 2018; Volume 12: 1815–1822
  24. Popovic M, Campos-Möller X, Schlenker MB, et al. Efficacy and Safety of Femtosecond Laser-Assisted Cataract Surgery Compared with Manual Cataract Surgery. Ophthalmology 2016; 123: 2113–2126
  25. Chen X, Xiao W, Ye S, et al. Efficacy and safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract: a meta-analysis of randomized controlled trials. Sci Rep 2015; 5: 13123

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