A PROSPECTIVE COMPARATIVE STUDY ON ENDOTHELIAL CORNEAL CELL AFTER CATARACT SURGERY USING TORSIONAL VS LONGITUDINAL PHACOEMULSIFICATION
Objectives: Our aim was to compare endothelial corneal cell changes after cataract surgery performed with Torsional and Longitudinal phacoemulsification in patient with senile cataract.
Methods: In this prospective study, the patients were divided into two groups, 24 eyes underwent cataract surgery using Torsional (OZil Infiniti Vision System, Alcon) and 23 eyes using Longitudinal phacoemulsification (Stelaris, Bausch & Lomb). Preoperative, 1 day, and 1-week post-operative examinations on endothelial corneal cells were performed using specular microscope. Cataracts were subdivided according to the LOCS III grading of nucleus. Intraoperative parameters using phacoemulsification time were evaluated.
Results: On the results of CCT at 1 day and 1-week post-operative, there were significant changes in group Torsional and Longitudinal 601±68.67; 562.22±45.48 (p=0.033) and 561,71±36,37; 519.52±79.93 (p = 0.015). However, there were no significant changes of CD, CV, HEX 1 day and 1 week post operatively between two groups. The phacoemulsification time was lower in group Torsional 17.11±15.86 seconds than group Longitudinal 18.53±15.46 seconds (p=0.595) but not significantly different.
Conclusions: Torsional phacoemulsification outperforms the Longitudinal with a lower phacoemulsification time on soft and medium cataracts, but the differences were not significant. Torsional caused more corneal edema at 1 day and 1 week postoperative significantly and more endothelial cell losses but insignificantly.
2. Nampradit K, Kongsap P. The Visual Outcomes and Complications of Manual Small Incision Cataract Surgery and Phacoemulsification : Long Term Results. Rom J Ophthalmol. 2021 Jan-Mar; 65(1): 31–37.
3. Hutauruk JA, Prakoso H, Riyanto SB, editors. Katarak dan Fakoemulsifikasi. 2nd ed. Jakarta: Indonesian Society of Cataract and Refractive Surgery. 2018.
4. Leon P, Umari I, Mangogna A, Zanei A, Tognetto D. An Evaluation of Intraoperative and Postoperative Outcomes of Torsional Mode Versus Longitudinal Ultrasound Mode Phacoemulsification: a Meta-analysis. Int J Ophthalmol 2016;9(6): 890-897
5. Sorrentino FS, Matteini S, Imburgia A, Bonifazzi C, Sebastiani A, Parmeggiani F. Torsional Phacoemulsification: A Pilot Study to Revise The "Harm Scale" Evaluating The Endothelial Damage and The Visual Acuity After Cataract Surgery. PLoS One. 2017 Oct 26;12(10):e0186975.
6. Mehra R, Gupta M, Shakeel T, Dasgupta S . Linear versus Torsional Phacoemulsification: A Comparative Study. Delhi J Ophthalmol 2019;29;48-52.
7. El Sobky H, Zaky M NH. Evaluation of Corneal Endothelial Changes after Posterior Capsule Rupture during Phacoemulsification using Specular Microscope. Menoufia Med J. 2020;33:1218–25.
8. Christakis PG, Braga-mele RM. Intraoperative Performance and Postoperative Outcome Comparison of Longitudinal, Torsional, and Transversal Phacoemulsification Machines. J Cart Refract Surg. 2012;38(2):234–41.
9. Reuschel A, Bogatsch H, Wiedemann R. Long-Term Comparison of Endothelial Changes Between Torsional and Longitudinal Phacoemulsification. Asia Pac J Ophthalmol (Phila). 2012 May-Jun;1(3):152-7.
10. Sawhney A, Sridhar U, Tandon C. Comparison of Corneal Endothelial Cell Loss Between Torsional and Linear Phacoemulsification. Delhi J Ophthalmol. 2014;25:23–7.
11. Sharif-kashani P, Fanney D, Injev V. Comparison of Occlusion Break Responses and Vacuum Rise Times of Phacoemulsification Systems. BMC Ophthalmol. 2014;14(1):1–7.
12. Hwang HB, Lyu B, Yim HB, Lee NY. Endothelial Cell Loss after Phacoemulsification according to Different Anterior Chamber Depths. J Ophthalmol. 2015: 210716.
13. Tang Y, Chen X, Zhang X, Tang Q, Liu S, Yao K. Clinical Evaluation of Corneal Changes After Phacoemulsification In Diabetic and Non-Diabetic Cataract Patients, A Systematic Review And Meta-Analysis. Sci Rep. 2017; 7: 14128.
14. Chen HC, Huang CW, Yeh LK, Hsiao FC, Hsueh YJ, Meir YJ, et al. Accelerated Corneal Endothelial Cell Loss after Phacoemulsification in Patients with Mildly Low Endothelial Cell Density. J Clin Med. 2021 May 24;10(11):2270.
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