To compare the 1-year outcome of 1.8 mm and 2.2 mm microcoaxial cataract surgery (MCCS) versus 2.75 mm conventional cataract surgery (CCS).

The present study evaluated 120 eyes (40 eyes in each group). The mean ultrasound power, ultrasound time (UST), and cumulative dissipated energy (CDE) were measured preoperatively and at 1 day, 1, 2, 6 months, and 1 year postoperative. Visual acuity, number of corneal endothelial cells, and surgically induced astigmatism (SIA) were compared.

In LOCS III NO4, 1.8 mm MCCS showed a statistically higher ultrasound time ( p -value = 0.031) and CDE ( p -value = 0.029), and the day 1 corneal thickness increase was relatively higher in 1.8 mm MCCS ( p -value = 0.043) than other two groups. There were no differences in postoperative 1 year visual acuity or number of corneal endothelial cells among the groups. SIA was significantly lower in 1.8 mm and 2.2 mm MCCS compared to that of the conventional treatment ( p -value = 0.046).

There were no differences in postoperative 1 year mean endothelial cell density or corrected visual acuity between 1.8 and 2.2 mm MCCS and CCS at all cataract densities. The 1.8 mm and 2.2 mm MCCS techniques were as safe and effective as CCS, and SIA in 1.8 mm and 2.2 mm MCCS was significantly lower than that of CCS.