Comparison of needle versus forceps capsulorhexis in cataract surgery

Purpose:To compare needle versus forceps capsulorhexis in routine senile cataract surgery. Methods:60 consecutive uneventful senile cataract phacosurgeries operated with topical anaesthesia through a 3,2 mm temporal corneal tunnel were enrolled in this prospective study. In 30 cases capsulorhexis was performed by means of a manually prepared 25 G needle (0.4 mm thick), whereas a regular capsulorhexis forceps (minimum thickness of 0.8 mm) was used in the other cases. Size of the rhexis, duration of surgery, early postop course and complications, and confocal microscopy corneal changes (central subbasal nerve density at day -1 and 30) were evaluated. Statistical comparison between the two procedures and multivariate analysis of variables involved in surgeries were performed. Results:Size (4.0±1.2 v 4.8±1.3, p=0.03) and regularity of the rhexis were significantly less with the needle procedure which induced less corneal changes at confocal microscopy (change in central fiber density, -1.6±1.8 v -2.5±2.3, p=0.05). The other variables examined were not significantly different. Conclusions:Capsulorhexis with needle should be considered as a valuable procedure alternative to the widespread forceps technique, particularly in cases where reduced corneal damage is desirable and in view of the increasingly reduced size of the corneal tunnel.