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Study flow diagram.
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Figure 1

Study flow diagram.

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Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 1 Mean postoperative surgically induced astigmatism at 3 months.
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Analysis 1.1

Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 1 Mean postoperative surgically induced astigmatism at 3 months.

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Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 2 Mean postoperative best‐corrected visual acuity at 3 months.
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Analysis 1.2

Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 2 Mean postoperative best‐corrected visual acuity at 3 months.

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Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 3 Mean change of endothelial cell loss at 3 months.
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Analysis 1.3

Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 3 Mean change of endothelial cell loss at 3 months.

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Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 4 Mean change of central corneal thickness at 3 months.
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Analysis 1.4

Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 4 Mean change of central corneal thickness at 3 months.

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Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 5 Intraoperative use of cumulative dissipated energy.
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Analysis 1.5

Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 5 Intraoperative use of cumulative dissipated energy.

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Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 6 Intraoperative use of balanced salt solution.
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Analysis 1.6

Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 6 Intraoperative use of balanced salt solution.

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Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 7 Surgical time.
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Analysis 1.7

Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 7 Surgical time.

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Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 8 Phacoemulsification time.
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Analysis 1.8

Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 8 Phacoemulsification time.

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Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 9 Corneal edema.
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Analysis 1.9

Comparison 1 Larger coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 9 Corneal edema.

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Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 1 Mean postoperative surgically induced astigmatism at 3 months.
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Analysis 2.1

Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 1 Mean postoperative surgically induced astigmatism at 3 months.

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Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 2 Mean postoperative best‐corrected visual acuity at 3 months.
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Analysis 2.2

Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 2 Mean postoperative best‐corrected visual acuity at 3 months.

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Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 3 Mean change of endothelial cell loss at 3 months.
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Analysis 2.3

Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 3 Mean change of endothelial cell loss at 3 months.

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Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 4 Mean change of central corneal thickness at 3 months.
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Analysis 2.4

Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 4 Mean change of central corneal thickness at 3 months.

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Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 5 Intraoperative use of cumulative dissipated energy.
Figuras y tablas -
Analysis 2.5

Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 5 Intraoperative use of cumulative dissipated energy.

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Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 6 Intraoperative use of balanced salt solution.
Figuras y tablas -
Analysis 2.6

Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 6 Intraoperative use of balanced salt solution.

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Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 7 Surgical time.
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Analysis 2.7

Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 7 Surgical time.

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Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 8 Phacoemulsification time.
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Analysis 2.8

Comparison 2 Smaller coaxial microincision cataract surgery versus standard phacoemulsification, Outcome 8 Phacoemulsification time.

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Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 1 Mean postoperative surgically induced astigmatism at 3 months.
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Analysis 3.1

Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 1 Mean postoperative surgically induced astigmatism at 3 months.

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Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 2 Mean postoperative best‐corrected visual acuity at 3 months.
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Analysis 3.2

Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 2 Mean postoperative best‐corrected visual acuity at 3 months.

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Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 3 Mean endothelial cell loss at 3 months.
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Analysis 3.3

Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 3 Mean endothelial cell loss at 3 months.

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Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 4 Mean change of central corneal thickness at 3 months.
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Analysis 3.4

Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 4 Mean change of central corneal thickness at 3 months.

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Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 5 Intraoperative use of cumulative dissipated energy.
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Analysis 3.5

Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 5 Intraoperative use of cumulative dissipated energy.

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Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 6 Intraoperative use of balanced salt solution.
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Analysis 3.6

Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 6 Intraoperative use of balanced salt solution.

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Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 7 Surgical time.
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Analysis 3.7

Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 7 Surgical time.

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Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 8 Phacoemulsification time.
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Analysis 3.8

Comparison 3 Smaller versus larger coaxial microincision cataract surgery, Outcome 8 Phacoemulsification time.

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Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 1 Mean postoperative surgically induced astigmatism at 3 months.
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Analysis 4.1

Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 1 Mean postoperative surgically induced astigmatism at 3 months.

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Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 2 Mean postoperative surgically induced astigmatism at 6 months.
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Analysis 4.2

Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 2 Mean postoperative surgically induced astigmatism at 6 months.

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Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 3 Mean postoperative best‐corrected visual acuity at 3 months.
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Analysis 4.3

Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 3 Mean postoperative best‐corrected visual acuity at 3 months.

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Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 4 Mean endothelial cell loss at 3 months.
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Analysis 4.4

Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 4 Mean endothelial cell loss at 3 months.

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Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 5 Postoperative central corneal thickness at 3 months.
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Analysis 4.5

Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 5 Postoperative central corneal thickness at 3 months.

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Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 6 Intraoperative use of cumulative dissipated energy.
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Analysis 4.6

Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 6 Intraoperative use of cumulative dissipated energy.

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Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 7 Surgical time.
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Analysis 4.7

Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 7 Surgical time.

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Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 8 Phacoemulsification time.
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Analysis 4.8

Comparison 4 Biaxial microincision cataract surgery versus standard phacoemulsification, Outcome 8 Phacoemulsification time.

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Summary of findings for the main comparison. Larger coaxial microincision cataract surgery (C‐MICS) versus standard phacoemulsification

Larger C‐MICS compared with standard phacoemulsification for age‐related cataract

Patient or population: adults with age‐related cataract

Settings: eye clinics

Intervention: larger C‐MICS with 2.2‐millimeter incision

Comparison: standard phacoemulsification with about 3.0‐millimeter incision

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No. of eyes
(studies)

Certainty of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Standard phacoemulsification

Larger C‐MICS

Mean postoperative surgically induced astigmatism

Follow‐up: 3 months

The mean surgically induced astigmatism was 0.7 to 1.34 diopters.

The mean surgically induced astigmatism in the intervention groups was 0.19 diopters lower (0.30 to 0.09 diopters lower).

‐

996
(8 RCTs)

⊕⊝⊝⊝
very lowa,b

A lower diopter value is a better clinical outcome.

Mean postoperative best‐corrected visual acuity

Follow‐up: 3 months

The mean best‐corrected visual acuity was 0.05 to 0.11 logMAR.

The mean best‐corrected visual acuity in the intervention groups was 0.00 logMAR lower (0.02 logMAR lower to 0.02 logMAR higher).

‐

242
(3 RCTs)

⊕⊕⊝⊝
lowc

Mean endothelial cell loss

Follow‐up: 3 months

The mean of endothelial cell loss ranged across control groups was 2054.0 to 2339.0 cells/mm2.

The mean change of endothelial cell loss in the intervention groups was 7.23 cells/mm2 lower (78.66 cells/mm2 lower to 64.20 cells/mm2 higher).

‐

596

(4 RCTs)

⊕⊕⊝⊝
lowd

Little or no difference between groups is a clinically positive result.

Central corneal thickness

Follow‐up: 3 months

The mean change of central corneal thickness was 9.24 μm.

The mean central corneal thickness ranged across control groups from 546.0 to 580.0 μm.

The mean change of central corneal thickness in the intervention groups was 0.68 μm lower (3.26 μm lower to 1.90 μm higher).

‐

487

(5 RCTs)

⊕⊕⊝⊝
lowd

Hwang 2016 did not report the standard deviation, but reported that the mean % decrease in central corneal thickness was 1.00 in the 2.2‐millimeter group and 0.31 in the 2.75‐millimeter group.

Little or no difference between groups is a clinically positive result.

Adverse events (corneal edema)

Follow‐up: 3 months

46 per 1000

47 per 1000

(19 to 122)

RR 1.02

(0.40 to 2.63

362

(1 RCT)

Wang 2009 reported "no intraoperative complications."

Quality of life

Not reported

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; RCT: randomized controlled trial; RR: risk ratio

GRADE Working Group grades of evidence
High‐certainty: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate‐certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low‐certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low‐certainty: We are very uncertain about the estimate.

aDowngraded two levels for risk of bias, as one study was at high risk of selection and attrition bias, while another study was at high risk of reporting bias.
bDowngraded one level for unexplained statistical heterogeneity.
cDowngraded two levels for risk of bias, as the studies were at unclear risk of selection and attrition bias.
dDowngraded two levels for risk of bias, as the studies were at unclear risk of selection, performance, detection, and attrition bias.

Figuras y tablas -
Summary of findings for the main comparison. Larger coaxial microincision cataract surgery (C‐MICS) versus standard phacoemulsification
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Summary of findings 2. Smaller coaxial microincision cataract surgery (C‐MICS) versus standard phacoemulsification

Smaller C‐MICS compared with standard phacoemulsification for age‐related cataract

Patient or population: adults with age‐related cataract

Settings: eye clinics

Intervention: smaller C‐MICS with 1.8‐millimeter incision

Comparison: standard phacoemulsification with about 3.0‐millimeter incision

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No. of eyes
(studies)

Certainty of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Standard phacoemulsification

Smaller C‐MICS

Mean postoperative surgically induced astigmatism

Follow‐up: 3 months

The mean postoperative surgically induced astigmatism ranged across control groups from 0.03 to 0.94 diopters.

The mean postoperative surgically induced astigmatism in the intervention groups was 0.23 lower (0.34 diopters to 0.13 diopters lower).

‐

561
(5 RCTs)

⊕⊝⊝⊝
very lowa,b

A lower diopter value is a better clinical outcome.

Mean postoperative best‐corrected visual acuity

Follow‐up: 2 to 3 months

The mean postoperative best‐corrected visual acuity ranged across control groups from
0.05 to 0.06 logMAR units.

The mean postoperative best‐corrected visual acuity in the intervention groups was 0.02 logMAR units lower (0.03 logMAR units lower to 0.00 logMAR units).

‐

192
(3 RCTs)

⊕⊕⊝⊝
lowc

Mean change of endothelial cell loss

Follow‐up: 3 months

The mean change of endothelial cell loss ranged across control groups from 2231.22 to 3077.0 cells/mm2.

The mean change of endothelial cell loss in the intervention groups was
7.56 cells/mm2 higher
(67.65 cells/mm2 lower to 82.77 cells/mm2 higher).

‐

380
(5 RCTs)

⊕⊕⊝⊝
lowa

Mean change of central corneal thickness

Follow‐up: 3 months

The mean change of central corneal thickness ranged across control groups from 3.74 to 63.5 μm.

The mean change of central corneal thickness in the intervention groups was

1.52 μm lower (6.29 μm lower to 3.25 μm higher).

‐

245
(3 RCTs)

⊕⊕⊝⊝
lowa

Adverse events

Follow‐up: 3 months

None of the trials reported on adverse events.

Quality of life

Not reported

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; RCT: randomized controlled trial

GRADE Working Group grades of evidence
High‐certainty: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate‐certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low‐certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low‐certainty: We are very uncertain about the estimate.

aDowngraded two levels for high risk of selection, performance, and detection bias.
bDowngraded two levels for unexplained statistical heterogeneity, as the I2 was greater than 70%.
cDowngraded two levels for unclear risk of selection, performance, detection, attrition, and reporting bias.

Figuras y tablas -
Summary of findings 2. Smaller coaxial microincision cataract surgery (C‐MICS) versus standard phacoemulsification
Ir a la tabla de la revisión
Summary of findings 3. Smaller coaxial microincision cataract surgery (C‐MICS) versus larger C‐MICS

Smaller coaxial microincision cataract surgery (C‐MICS) compared with larger C‐MICS for age‐related cataract

Patient or population: adults with age‐related cataract

Settings: eye clinics

Intervention: smaller C‐MICS with 1.8‐millimeter incision

Comparison: larger C‐MICS with 2.2‐millimeter incision

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No. of eyes
(studies)

Certainty of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Larger C‐MICS

Smaller C‐MICS

Mean postoperative surgically induced astigmatism

Follow‐up: 3 months

The mean postoperative surgically induced astigmatism ranged across control groups from 0.48 to 1.08 diopters.

The mean postoperative surgically induced astigmatism in the intervention groups was
0.04 diopters higher
(0.09 diopters lower to 0.16 diopters higher).

‐

259
(3 RCTs)

⊕⊕⊝⊝
lowa

A lower diopter value is a better clinical outcome.

Mean postoperative best‐corrected visual acuity

Follow‐up: 3 months

The mean postoperative best‐corrected visual acuity ranged across control groups from
‐0.06 logMAR units to 0.27 logMAR units.

The mean postoperative best‐corrected visual acuity in the intervention groups was 0.01 logMAR units higher (0.01 logMAR units lower to 0.04 logMAR units higher).

‐

200
(3 RCTs)

⊕⊕⊝⊝
lowa

Mean change of endothelial cell loss

Follow‐up: 3 months

The mean change in endothelial cell loss was 2303.0 cells/mm2.

The mean change in endothelial cell loss was 213.00 cells/mm2 higher (11.15 to 414.85 cells/mm2 higher).

‐

70

(1 RCT)

⊕⊝⊝⊝
very lowb,c

Mean central corneal thickness

Follow‐up: 3 months

The mean change in central corneal thickness was 2.99 μm.

The mean change in central corneal thickness was 0.45 μm higher (2.70 μm lower to 3.60 μm higher).

‐

100
(1 RCT)

⊕⊕⊝⊝
lowc

Adverse events

Follow‐up: end of trial

None of the trials reported on adverse events.

Quality of life

Not reported

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; RCT: randomized controlled trial

GRADE Working Group grades of evidence
High‐certainty: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate‐certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low‐certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low‐certainty: We are very uncertain about the estimate.

aDowngraded two levels for unexplained statistical heterogeneity, as the I2 was greater than 70%.
bDowngraded one level for risk of bias, as the studies were at unclear risk of selection, performance, detection, and attrition bias.
cDowngraded two levels for imprecision of results, as only one trial reported endothelial cell loss at three months' follow‐up and it is possible that the optimal information size has not been reached.

Figuras y tablas -
Summary of findings 3. Smaller coaxial microincision cataract surgery (C‐MICS) versus larger C‐MICS
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Summary of findings 4. Biaxial microincision cataract surgery (B‐MICS) versus standard phacoemulsification

B‐MICS compared with standard phacoemulsification for age‐related cataract

Patient or population: adults with age‐related cataract

Settings: eye clinics

Intervention: B‐MICS with equal to or smaller than 1.5‐millimeter incision

Comparison: standard phacoemulsification with about 3.0‐millimeter incision

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No. of eyes
(studies)

Certainty of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Standard phacoemulsification

B‐MICS

Mean postoperative surgically induced astigmatism

Follow‐up: 3 months

The mean postoperative surgically induced astigmatism ranged across control groups from 0.12 diopters to 0.44 diopters.

The mean postoperative surgically induced astigmatism in the intervention groups was
0.01 diopters lower
(0.03 diopters lower to 0.01 diopters higher).

‐

368
(2 RCTs)

⊕⊕⊕⊝
moderatea

A lower diopter value is a better clinical outcome.

Mean postoperative best‐corrected visual acuity

Follow‐up: 3 months

The mean postoperative best‐corrected visual acuity ranged across control groups from
0.11 logMAR units to 0.97 logMAR units.

The mean postoperative best‐corrected visual acuity in the intervention groups was 0.02 logMAR units lower (0.04 logMAR units lower to 0.00 LogMAR units).

‐

464
(3 RCTs)

⊕⊕⊝⊝
lowb

Mean endothelial cell loss

Follow‐up: 3 months

The mean endothelial cell loss in the control groups was 2410 cells/mm2.

The mean endothelial cell loss in the intervention groups was
55.83 cells/mm2 higher

(34.93 cells/mm2 lower to 146.59 cells/mm2 higher).

‐

280
(1 RCT)

⊕⊕⊝⊝
lowc

Postoperative central corneal thickness

Follow‐up: 3 months

The mean change in central corneal thickness in the control group was 546 μm.

The mean change of central corneal thickness in the intervention groups was

0.10 μm higher (14.04 μm lower to 14.24 μm higher).

‐

90
(1 RCT)

⊕⊕⊝⊝
lowc

Adverse events

Follow‐up: end of study

None of the trials reported on adverse events.

Quality of life

Not reported

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; RCT: randomized controlled trial

GRADE Working Group grades of evidence
High‐certainty: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate‐certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low‐certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low‐certainty: We are very uncertain about the estimate.

aDowngraded one level for risk of bias, as the trials were at unclear risk of selection and reporting bias.
bDowngraded two levels for unexplained statistical heterogeneity, as the I2 was greater than 70%.
cDowngraded two levels for imprecision, as only one trial reported endothelial cell loss at three months' follow‐up and it is possible that the optimal information size has not been reached.

Figuras y tablas -
Summary of findings 4. Biaxial microincision cataract surgery (B‐MICS) versus standard phacoemulsification
Ir a la tabla de la revisión
Comparison 1. Larger coaxial microincision cataract surgery versus standard phacoemulsification

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean postoperative surgically induced astigmatism at 3 months Show forest plot

8

996

Mean Difference (IV, Random, 95% CI)

‐0.19 [‐0.30, ‐0.09]

2 Mean postoperative best‐corrected visual acuity at 3 months Show forest plot

3

242

Mean Difference (IV, Random, 95% CI)

0.00 [‐0.02, 0.02]

3 Mean change of endothelial cell loss at 3 months Show forest plot

4

596

Mean Difference (IV, Random, 95% CI)

‐7.23 [‐78.66, 64.20]

4 Mean change of central corneal thickness at 3 months Show forest plot

5

487

Mean Difference (IV, Random, 95% CI)

‐0.68 [‐3.26, 1.90]

5 Intraoperative use of cumulative dissipated energy Show forest plot

6

784

Mean Difference (IV, Random, 95% CI)

‐0.30 [‐1.33, 0.72]

6 Intraoperative use of balanced salt solution Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

7 Surgical time Show forest plot

3

314

Mean Difference (IV, Fixed, 95% CI)

‐0.05 [‐0.26, 0.16]

8 Phacoemulsification time Show forest plot

4

608

Mean Difference (IV, Random, 95% CI)

‐0.96 [‐3.48, 1.56]

9 Corneal edema Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 1. Larger coaxial microincision cataract surgery versus standard phacoemulsification
Ir a la tabla de la revisión
Comparison 2. Smaller coaxial microincision cataract surgery versus standard phacoemulsification

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean postoperative surgically induced astigmatism at 3 months Show forest plot

5

561

Mean Difference (IV, Random, 95% CI)

‐0.23 [‐0.34, ‐0.13]

2 Mean postoperative best‐corrected visual acuity at 3 months Show forest plot

3

192

Mean Difference (IV, Fixed, 95% CI)

‐0.02 [‐0.03, ‐0.00]

3 Mean change of endothelial cell loss at 3 months Show forest plot

5

380

Mean Difference (IV, Random, 95% CI)

7.56 [‐67.65, 82.77]

4 Mean change of central corneal thickness at 3 months Show forest plot

3

245

Mean Difference (IV, Fixed, 95% CI)

‐1.52 [‐6.29, 3.25]

5 Intraoperative use of cumulative dissipated energy Show forest plot

2

360

Mean Difference (IV, Fixed, 95% CI)

‐4.25 [‐5.43, ‐3.07]

6 Intraoperative use of balanced salt solution Show forest plot

2

130

Mean Difference (IV, Fixed, 95% CI)

‐1.93 [‐6.32, 2.46]

7 Surgical time Show forest plot

2

130

Mean Difference (IV, Fixed, 95% CI)

‐0.14 [‐0.35, 0.07]

8 Phacoemulsification time Show forest plot

2

130

Mean Difference (IV, Fixed, 95% CI)

8.20 [2.88, 13.52]
Figuras y tablas -
Comparison 2. Smaller coaxial microincision cataract surgery versus standard phacoemulsification
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Comparison 3. Smaller versus larger coaxial microincision cataract surgery

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean postoperative surgically induced astigmatism at 3 months Show forest plot

3

259

Mean Difference (IV, Fixed, 95% CI)

0.04 [‐0.09, 0.16]

2 Mean postoperative best‐corrected visual acuity at 3 months Show forest plot

3

200

Mean Difference (IV, Fixed, 95% CI)

0.01 [‐0.01, 0.04]

3 Mean endothelial cell loss at 3 months Show forest plot

1

70

Mean Difference (IV, Fixed, 95% CI)

213.00 [11.15, 414.85]

4 Mean change of central corneal thickness at 3 months Show forest plot

1

100

Mean Difference (IV, Fixed, 95% CI)

0.45 [‐2.70, 3.60]

5 Intraoperative use of cumulative dissipated energy Show forest plot

4

300

Mean Difference (IV, Random, 95% CI)

‐0.33 [‐3.72, 3.07]

6 Intraoperative use of balanced salt solution Show forest plot

3

210

Mean Difference (IV, Fixed, 95% CI)

1.04 [‐2.45, 4.53]

7 Surgical time Show forest plot

2

180

Mean Difference (IV, Fixed, 95% CI)

0.33 [0.12, 0.55]

8 Phacoemulsification time Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 3. Smaller versus larger coaxial microincision cataract surgery
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Comparison 4. Biaxial microincision cataract surgery versus standard phacoemulsification

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean postoperative surgically induced astigmatism at 3 months Show forest plot

2

368

Mean Difference (IV, Fixed, 95% CI)

‐0.01 [‐0.03, 0.01]

2 Mean postoperative surgically induced astigmatism at 6 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Mean postoperative best‐corrected visual acuity at 3 months Show forest plot

3

464

Mean Difference (IV, Fixed, 95% CI)

‐0.02 [‐0.04, ‐0.00]

4 Mean endothelial cell loss at 3 months Show forest plot

1

280

Mean Difference (IV, Fixed, 95% CI)

55.83 [‐34.93, 146.59]

5 Postoperative central corneal thickness at 3 months Show forest plot

1

90

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐14.04, 14.24]

6 Intraoperative use of cumulative dissipated energy Show forest plot

2

370

Mean Difference (IV, Fixed, 95% CI)

‐5.27 [‐6.58, ‐3.97]

7 Surgical time Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

8 Phacoemulsification time Show forest plot

2

370

Mean Difference (IV, Fixed, 95% CI)

‐5.58 [‐9.52, ‐1.63]
Figuras y tablas -
Comparison 4. Biaxial microincision cataract surgery versus standard phacoemulsification
Ir a la tabla de la revisión