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Comparison of effective phacoemulsification time and corneal endothelial cell loss using three different ultrasound
Taru Dewan1, Praveen K Malik1, Preeti Tomar1
1Department of Ophthalmology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India.
Purpose:
Comparison of three ultrasound (US) frequencies for phacoemulsification of hard cataracts to determine a frequency that makes phacoemulsification more efficacious and safer.
Methods:
A randomized controlled trial was undertaken at a medical college and hospital. In total, 207 patients with grade 5.6-6.9 (LOCS III) senile cataract were randomized into three groups. Group I underwent phacoemulsification with 28-kHz frequency, group II with 42-kHz frequency, and group III with 53-kHz frequency. The effective phacoemulsification time (EPT) and estimated fluid usage (EFU) were compared intraoperatively. The endothelial cell parameters were analyzed for 6 months.
Results:
The groups were matched for age (P = 0.467), gender (P = 0.497), nuclear grade (P = 0.321), and anterior chamber depth (P = 0.635). The EPT and EFU were significantly lower in group III, compared to group II and group I, with P < 0.0001 and P < 0.0001, respectively. Postoperatively, the endothelial cell density (ECD) was significantly higher in group III at 1 month (P < 0.0001), 3 months (P < 0.0001), and 6 months (P < 0.0001). The percentages of ECD loss were also significantly lower in group III; the difference was statistically significant (P < 0.0001) up to 6 months postoperatively.
Conclusion:
Higher frequency ultrasound was associated with a lower EPT and EFU as well as better endothelial preservation than lower frequencies in hard cataracts.
