Abstract
This retrospective study aims to evaluate the design, intraoperative stability, and postoperative anterior chamber sealing efficacy of mortise and tenon limbal incisions (MTLIs) compared to clear corneal incisions (CCIs) in phacoemulsification cataract surgery, focusing on its safety and effectiveness. 564 patients (MTLI = 282, CCI = 282) undergoing phacoemulsification were stratified by Emery-Little nuclear grades (III-V). Primary outcomes included stromal hydration necessity and more than 3 intraoperative anterior chamber collapses. Secondary outcomes assessed complications, such as Descemet membrane detachment, DMD). MTLI significantly reduced stromal hydration rates (Grade III: 7.06% vs. 55.74%; Grade IV: 18.87% vs. 83.67%; Grade V: 61.02% vs. 100%; p < 0.0001) and anterior chamber collapses (Grade III: 11.18% vs. 58.47%; Grade IV: 22.64% vs. 87.76%; Grade V: 62.71% vs. 100%; p < 0.0001) compared to CCI. No DMD occurred with MTLI, while two cases arose with CCI. MTLI demonstrates superior performance over CCI in terms of intraoperative and postoperative stability, reducing the need for stromal hydration and lowering the risk of anterior chamber collapse. This technique is easy to learn, beneficial for both novice and experienced surgeons, and offers significant clinical advantages without additional financial burden to the patient.