Outcomes of Phacoemulsification With Torsional Ultrasound

A Randomised Trial of Torsional Ultrasound Versus Longitudinal Ultrasound During Phacoemulsification of Age-related Cataracts: Comparison of Intra-operative Performance and Impact on Post-operative Endothelium Integrity

To determine the differences in intra-operative complications, surgical duration, fluid usage, corneal thickness and endothelium cell density in eyes undergoing microcoaxial phacoemulsification (MCP) either with Torsional or longitudinal ultrasound during the surgery and at post-operative day 1, 1 month and 3 months.

Introduced in mid 2006, torsional ultrasound (OZil, Infiniti Vision System, Alcon Laboratories, Texas, USA) uses rotational oscillations at ultrasonic frequencies to emulsify cataractous lens material in a seamless cutting motion from a tip that oscillates laterally. The side-to-side movement of the phaco tip produces minimal repulsion of lens material from the phaco tip resulting in improved followability. Clinically this translates into more effective lens removal with torsional phaco in comparison to the conventional ultrasound mode.to test this in a clinical scenario we undertook this study.

Inclusion Criteria:

• patients 55 years and older with a senile cataract grades 1 to 5 nuclear sclerosis based on Emery's classification,
• endothelial cell density > 1500 cells/mm2,
• anterior chamber depth > 2.4 mm, and
• a dilated pupil > 7 mm.

Exclusion Criteria:

• eyes with pseudoexfoliation,
• mature, traumatic, or complicated cataracts,
• history of previous intra-ocular surgery, glaucoma, uveitis, and
• patients who were unable to comply with follow-up examinations.