Corneal Endothelial Changes Following Tortional Versus Longitudinal Phacoemulsification

Document Type : Original Articles

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Mansoura Ophthalmic Center, Mansoura University

Abstract

Aim: To study the corneal endothelial changes that occur following tortional phacoemulsification and compare it with that occuring after longitudinal phacoemulsification in cataract surgery.
METHODS: This is prospective randomized study for comparative analysis of corneal endothelial modifications held on 60eyes of 60patients with senile immature cataract with senile cataract of different grades of nuclear hardness for which torsional phaco surgery was performed to 30eyes and longitudinal phaco surgery was performed to 30eyes.
RESULTS: There was highly statistically significant endothelial cell loss throughout the study in the two groups, With no significant difference between the two groups by the third month (P=0.5).There was statistically significant decrease in the mean ECC in the two groups post-operatively at 1week(P<0.001*),1month(P<0.001*)and 3months(P<0.001*), compared to pre-operative mean ECC. The most significant decrease in ECC was at the first visit(1week follow up)in both groups (about6.5%in tortional group and 6.8% in longitudinal group). After 1month there is small decrease in both groups(2.2%decrease in tortional group and1.6%decrease in longitudinal group compared to 1wk results).After 3months there is slight decrease in both groups(1.1%decrease in tortional group and1.9%decrease in longitudinal group compared to 1mo results(P is the value that expresses the change between preoperative and postoperative endothelial counts P=0.161after one week, P=0.178after one month and P=0.404after three months).
CONCLUSION: The torsional mode provides an effective and safe method for cataract removal with lower energy usage as compared with longitudinal traditional phacoemulsification as regards the postoperative corneal endothelial cell loss and central corneal thickness.

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