Performance comparison of the Alcon Legacy 20000 1.1 mm TurboSonics and 0.9 mm MicroTip

To compare the efficiencies of the operative procedures, the changes in postoperative corneal endothelial cell density (ECD), and incision performance after cataract surgery using 2 different phacoemulsification tips.

Wolfe Clinic, Marshalltown, Iowa, USA.

A randomized prospective study of 119 consecutive cases was conducted. All patients were adults having phacoemulsification using a modified in situ fracture technique. All cases were done by 1 surgeon using the Alcon Legacy 20000 phacoemulsification machine with normal vacuum cassettes and tubing. One of 2 45 degree phacoemulsification tips was used: the 1.1 mm TurboSonics (n = 65) or the 0.9 mm MicroTip (n = 54). Measurements at the time of surgery included metered phacoemulsification time and mean phacoemulsification power. Corneal keratometry and ECD by contact specular microscopy were determined preoperatively and 10 weeks postoperatively.

The mean metered phacoemulsification time was statistically significantly different between the 2 groups: 1.1 mm TurboSonics = 1.25 minutes; 0.9 mm MicroTip = 1.66 minutes. The mean ultrasound power was also significantly different: 1.1 mm TurboSonics = 52.98%; 0.9 MicroTip = 49.07%. Loss of corneal ECD was not significantly different: 1.1 mm TurboSonic = 3.68%; 0.9 mm MicroTip = 5.79%. Mean diopters of induced incisional keratometric flattering was similar: 1.1 mm TurboSonics, 0.32 diopters (D) +/- 0.61 (SD); 0.9 mm MicroTip, 0.25 +/- 0.49 D. There were no cases of anterior radial capsule tear, posterior capsule tear, vitreous loss, iris aspiration, suture closure, or incision leak.

Although a longer mean metered phacoemulsification time was required with the 0.9 mm MicroTip, corneal endothelial cell loss and incisional keratometric performance were not different from those of cases in which the larger 1.1 mm TurboSonics tip was used. Both tips can be used effectively and safely for phacoemulsification of the human cataract.