Korean J Ophthalmol.  2010 Dec;24(6):336-340. 10.3341/kjo.2010.24.6.336.

The Comparison between Torsional and Conventional Mode Phacoemulsification in Moderate and Hard Cataracts

Affiliations
  • 1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. kmk9@snu.ac.kr
  • 2Seoul National University Hospital Clinical Research Institute, Seoul, Korea.
  • 3Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract

PURPOSE
To compare the intraoperative performances and postoperative outcomes of cataract surgery performed with longitudinal phacoemulsification and torsional phacoemulsification in moderate and hard cataracts.
METHODS
Of 85 patients who had senile cataracts, 102 eyes were operated on using the Infiniti Vision System. Preoperative examinations (slit lamp examination, mean central corneal thickness, and central endothelial cell counts) were performed for each patient. Cataracts were subdivided into moderate and hard, according to the Lens Opacities Classification System III grading of nucleus opalescence (NO). Eyes in each cataract group were randomly assigned to conventional and torsional phaco-mode. Intraoperative parameters, including ultrasound time (UST), cumulative dissipated energy (CDE), and the balanced salt solution plus (BSSP) volume utilized were evaluated. Best corrected visual acuity (BCVA) was checked on postoperative day 30; mean central corneal thickness and central endothelial cell counts were investigated on postoperative days 7 and 30.
RESULTS
Preoperative BCVA and mean grading of NO showed no difference in both groups. Preoperative endothelial cell count and central corneal thickness also showed no significant difference in both groups. In the moderate cataract group, the CDE, UST, and BSSP volume were significantly lower in the torsional mode than the longitudinal mode, but they did not show any difference in the hard cataract group. Torsional group showed less endothelial cell loss and central corneal thickening at postoperative day seven in moderate cataracts but showed no significant differences, as compared with the longitudinal group, by postoperative day 30.
CONCLUSIONS
Torsional phacoemulsification showed superior efficiency for moderate cataracts, as compared with longitudinal phacoemulsification, in the early postoperative stage.

Keyword

Balanced salt solution; Cataract; Corneal endothelial cell; Longitudinal phacoemulsification; Torsional phacoemulsification

MeSH Terms

Aged
Cataract/*classification/*pathology
Cataract Extraction/*methods
Cell Count
Cornea/ultrasonography
Endothelium, Corneal/pathology
Eyeglasses
Female
Humans
Male
Middle Aged
Phacoemulsification/*methods
Postoperative Period
Time Factors
Treatment Outcome
Visual Acuity

Cited by  4 articles

Comparison of Clinical Outcomes Between Torsional Phacoemulsification of Infiniti® and Longitudinal Phacoemulification of Stellaris® Through 2.2 mm Microincision
Sung A Lim, Hyung Bin Hwang, Hyun Seung Kim
J Korean Ophthalmol Soc. 2013;54(10):1508-1513.    doi: 10.3341/jkos.2013.54.10.1508.

Clinical Effects of an Improved Pump Reaction Rate and Automatic Occlusion Sensing System in Phacoemulsification
You Na Kim, Jin Ah Lee, Jae Yong Kim, Myoung Joon Kim, Hung Won Tchah
J Korean Ophthalmol Soc. 2018;59(11):1017-1023.    doi: 10.3341/jkos.2018.59.11.1017.

Influences on Astigmatism and Corneal Endothelium Using Two Different Incision Sizes and Mode of Phacoemulsification
Kyung Sup Shin, Jong Eun Lee, Si Hwan Choi
J Korean Ophthalmol Soc. 2013;54(2):237-244.    doi: 10.3341/jkos.2013.54.2.237.

Comparison of Clinical Outcomes between Torsional and Longitudinal Phacoemulsification
Ju Hee Noh, Moon Sun Jung
J Korean Ophthalmol Soc. 2015;56(7):1028-1037.    doi: 10.3341/jkos.2015.56.7.1028.


Reference

1. Zacharias J. Role of cavitation in the phacoemulsification process. J Cataract Refract Surg. 2008. 34:846–852.
2. Davison JA. Cumulative tip travel and implied followability of longitudinal and torsional phacoemulsification. J Cataract Refract Surg. 2008. 34:986–990.
3. Liu Y, Zeng M, Liu X, et al. Torsional mode versus conventional ultrasound mode phacoemulsification: randomized comparative clinical study. J Cataract Refract Surg. 2007. 33:287–292.
4. Zeng M, Liu X, Liu Y, et al. Torsional ultrasound modality for hard nucleus phacoemulsification cataract extraction. Br J Ophthalmol. 2008. 92:1092–1096.
5. Domingues FG, Moraes HV Jr, Yamane R. Comparative study of the density of corneal endothelial cells after phacoemulsification by the "divide and conquer" and "quick chop" techniques. Arq Bras Oftalmol. 2005. 68:109–115.
6. Xie LX, Yao Z, Huang YS, Ying L. Corneal endothelial damage and its repair after phacoemulsification. Zhonghua Yan Ke Za Zhi. 2004. 40:90–93.
7. Vasavada AR, Raj SM, Lee YC. NeoSoniX ultrasound versus ultrasound alone for phacoemulsification: randomized clinical trial. J Cataract Refract Surg. 2004. 30:2332–2335.
8. Mackool RJ, Brint SF. AquaLase: a new technology for cataract extraction. Curr Opin Ophthalmol. 2004. 15:40–43.
9. Vergés C, Llevat E. Laser cataract surgery: technique and clinical results. J Cataract Refract Surg. 2003. 29:1339–1345.
10. Güell JL, Vázquez M, Lucena J, et al. Phaco rolling technique. J Cataract Refract Surg. 2004. 30:2043–2045.
11. Sebban I. Phaco one-chop nucleotomy. J Cataract Refract Surg. 2002. 28:1325–1329.
12. Fine IH, Packer M, Hoffman RS. Use of power modulations in phacoemulsification. Choo-choo chop and flip phacoemulsification. J Cataract Refract Surg. 2001. 27:188–197.
13. Arshinoff SA. Phaco slice and separate. J Cataract Refract Surg. 1999. 25:474–478.
14. Wong T, Hingorani M, Lee V. Phacoemulsification time and power requirements in phaco chop and divide and conquer nucleofractis techniques. J Cataract Refract Surg. 2000. 26:1374–1378.
Full Text Links
  • KJO
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr