Reply: Microincision versus standard clear corneal cataract incisions
We appreciate the comments of Khokhar and Saxena. The cataract density was similar in the 2 groups, which was one of the strengths of our contralateral design. The cataract in the eye with the worse visual acuity was removed first, as is our standard procedure. This did not affect the cataract density between groups because we performed microincisional surgery in all left eyes and standard incision surgery in all right eyes to prevent bias during assignment. However, using the LOCS would have been useful to confirm the groups had similar cataract density. Other authors have shown that smaller incisions induce less astigmatism; however, this was not the goal of our study.
Khokhar and Saxena correctly state that the IOL or, more important, the IOL delivery system may stretch a microincisional wound, as seen in anterior segment OCT images. In our study, we used wound-assisted delivery with the Monarch delivery system (Alcon) and a “C” cartridge that has a diameter of 2.4 mm. Since our study was completed, a “D” cartridge has become available with the Monarch system. It has a diameter of 2.0 mm and is now used for our standard microincisional surgery.© 2009 by Lippincott Williams & Wilkins, Inc.