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

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 (all p < 0.05) but not at 1 month and 3 months postoperatively. TCAs were significantly decreased in both groups at 1 and 3 months postoperatively (all p < 0.05). There were no significant differences at any follow-up points in both groups (all p < 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 (all p < 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.