Comparison of Corneal Endothelial Cell Loss between Torsional and Linear Phacoemulsification

Abstract

Purpose: To compare corneal endothelial cell loss between Torsional phacoemulsification and Linear phacoemulsification systems for cataract surgery. Materials and Methods: A prospective randomized study of 100 eyes of 100 patients, who underwent cataract surgery between September 2011 and September 2013, was done. They were divided into two groups, 50 patients underwent torsional phacoemulsification (phaco) and 50 patients underwent linear phacoemulsification. All patients were operated on same phaco machine by the same surgeon. Corneal endothelial cell loss comparison between the two groups was done using specular microscopy. Patients more than 40 years of age of either sex with senile cataract of nuclear sclerosis (NS) grade 2 -3 (according to LOCSII) were included in the study. Age 70 years, corneal pathologies, poorly dilating pupil or posterior synechiae, pseudoexfoliation, subluxated lens, retinal pathology, glaucoma, diabetes mellitus, collagen vascular diseases, post refractive surgeries were excluded. Results: The mean percentage change of corneal endothelial cell density (ECD) from baseline was 3.5% in torsional group and 5.1% in linear group on postoperative day1 (p value= 0.026) 6.3% in torsional group and 9.8% in linear group on postoperative day 7 (p < 0.001) and 8.1% in torsional group and 10.78% in linear group on postoperative day 30 (p =0.001). Conclusions: There was statistically significant difference in corneal endothelial cell loss between torsional phacoemulsification and linear phacoemulsification systems for cataract surgery. The mean loss of corneal endothelial cells was statistically significantly less in torsional phacoemulsification than linear Phacoemulsification.

Keywords

• torsional phacoemulsification
• linear phacoemulsification
• corneal endothelial cell loss
• specular microscopy