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Updated: Jul 3, 2026

Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries
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Comparing the Efficacy Between Entry-Level Torsional and High-End Transverse Phacoemulsification Technologies.

Naren Shetty1, S J Tejal2, Rohitha Nayak2

  • 1Cataract and Refractive Surgery, Narayana Nethralaya, Bangalore, IND.

Cureus
|May 15, 2026
PubMed
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An affordable torsional phacoemulsification system demonstrated superior intraoperative efficiency compared to a high-end transverse system. This entry-level device requires less ultrasound energy and surgical time, offering comparable clinical outcomes.

Area of Science:

  • Ophthalmology
  • Surgical Technology
  • Cataract Surgery

Background:

  • Phacoemulsification is a key cataract surgery technique.
  • Comparing torsional and transverse phacoemulsification technologies is crucial for optimizing surgical outcomes and cost-effectiveness.
  • Evaluating entry-level devices against high-end systems aids informed clinical decisions.

Purpose of the Study:

  • To compare the intraoperative efficacy of torsional versus transverse phacoemulsification technologies.
  • To assess the clinical outcomes and efficiency of an entry-level torsional system against a high-end transverse system.
  • To determine if affordable phacoemulsification devices can provide uncompromised clinical care.

Main Methods:

  • Prospective comparative study with quasi-random allocation involving 120 eyes with immature cataracts.
Keywords:
cataractefficacyentry-level torsional systemphacoemulsificationtransverse phacoemulsification technology

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  • Phacoemulsification performed using either an entry-level torsional or a high-end transverse system by the same surgeon.
  • Preoperative and postoperative assessments included specular microscopy, pachymetry, and best-corrected visual acuity; intraoperative data and surgical videos were analyzed.

    • Main Results:

    • The torsional system used 47.12% less ultrasound time (p < 0.001) and 5.15% less surgical time (p = 0.056).
    • Torsional phacoemulsification demonstrated reduced chatter, better followability, and easier quadrant removal.
    • No significant differences were observed in postoperative visual acuity, pachymetry, or endothelial cell density between the groups.

    Conclusions:

    • The torsional phacoemulsification system is more efficient, requiring less ultrasound energy and marginally shorter surgical time.
    • The entry-level torsional system offers improved ease and efficiency in phacoemulsification compared to the transverse system.
    • Affordable phacoemulsification technologies can deliver optimal clinical results, supporting cost-effective cataract surgery.