Comparison of a torsional handpiece through microincision versus standard clear corneal cataract wounds

To directly compare intraoperative and clinical parameters using a torsional handpiece through microincision and standard clear corneal cataract wounds with appropriately configured tips and sleeves.

Duke University Eye Center, Durham, North Carolina, USA.

Cataracts in both eyes of 32 patients needing bilateral surgery were extracted using the OZil torsional handpiece. Tips and sleeve selections were optimized for the incision chosen. Right eyes had cataract surgery using a standard method consisting of a 2.8 mm incision with a 0.9 mm tapered 30-degree bevel Kelman configuration tip with a Microsleeve. Left eyes had cataract surgery through a 2.2 mm microincision using a 0.9 mm miniflared 45-degree bevel Kelman configuration tip with an Ultrasleeve. Intraoperative measurements included cumulative dissipated energy (CDE) and balanced salt solution use. Clinical measurements included preoperative and 1-day postoperative central corneal thickness (CCT), preoperative and 6-month postoperative endothelial cell count (ECC), and preoperative and postoperative anterior segment optical coherence tomography (AS-OCT).

Intraoperatively, the microincision (2.2 mm) group had less CDE use than the standard incision (2.8 mm) group (P= .001). Clinical measurements showed less ECC loss at 6 months in the microincision group (P<.05). No difference in CCT or AS-OCT findings was detected between groups.

Phacoemulsification using the OZil torsional handpiece through a microincision with an Ultrasleeve and a 45-degree miniflared tip showed favorable clinical and intraoperative characteristics such as less total energy use and less endothelial cell loss at 6 months. Further studies are warranted to substantiate these preliminary findings.