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Comparative studies between longitudinal and torsional modes in phacoemulsification, using active fluidics technology
Sushobhan Dasgupta1, Rohan Mehra1
1Department of Ophthalmology, SGRR-Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
Indian Journal of Ophthalmology
|September 26, 2018
Summary
Torsional phacoemulsification (TPKE) is more efficient than longitudinal phacoemulsification (LPKE) for cataract surgery, reducing ultrasound time and energy. Postoperative outcomes were similar between TPKE and LPKE modes.
Area of Science:
- Ophthalmology
- Surgical Technology
- Cataract Surgery
Background:
- Phacoemulsification is a common cataract surgery technique.
- Longitudinal (LPKE) and torsional (TPKE) modes are used, with varying efficiency.
- Active fluidics and specific tips may influence outcomes.
Purpose of the Study:
- To compare intra- and postoperative outcomes of LPKE versus TPKE.
- To evaluate phacoemulsification efficiency using active fluidics and the intrepid balanced tip.
- To assess the impact of different phacoemulsification modes on cataract surgery results.
Main Methods:
- A prospective randomized comparative study of 108 patients with senile cataracts (NO grades II-IV).
- Patients were randomly assigned to LPKE (n=54) or TPKE (n=54) using the Centurion system.
- Intraoperative (CDE, UST) and postoperative (ECL, CCT, BCVA) outcomes were evaluated.
Main Results:
- TPKE demonstrated significantly lower cumulative dissipated energy (CDE) and ultrasound time (UST) (P < 0.001) across all nuclear opalescence grades.
- Endothelial cell loss (ECL), central corneal thickness (CCT) change, and best-corrected visual acuity (BCVA) change were comparable between LPKE and TPKE groups (P > 0.05).
Conclusions:
- TPKE is a more efficient phacoemulsification mode than LPKE when using active fluidics and the intrepid balanced tip.
- Both modes yield comparable postoperative results regarding corneal health and visual acuity.
- TPKE offers advantages in reduced energy delivery during cataract surgery.
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