Intraoperative performance and postoperative outcome comparison of longitudinal, torsional, and transversal phacoemulsification machines.

Abstract

PURPOSE:

To compare the intraoperative performance and postoperative outcomes of 3 phacoemulsification machines that use different modes.

SETTING:

Kensington Eye Institute, Toronto, Ontario, Canada.

DESIGN:

Comparative case series.

METHODS:

This chart and video review comprised consecutive eligible patients who had phacoemulsification by the same surgeon using a Whitestar Signature Ellips-FX (transversal), Infiniti-Ozil-IP (torsional), or Stellaris (longitudinal) machine.

RESULTS:

The review included 98 patients. Baseline characteristics in the groups were similar; the mean nuclear sclerosis grade was 2.0 ± 0.8. There were no significant intraoperative complications. The torsional machine averaged less phacoemulsification needle time (83 ± 33 seconds) than the transversal (99 ± 40 seconds; P=.21) or longitudinal (110 ± 45 seconds; P=.02) machines; the difference was accentuated in cases with high-grade nuclear sclerosis. The torsional machine had less chatter and better followability than the transversal or longitudinal machines (P<.001). The torsional and longitudinal machines had better anterior chamber stability than the transversal machine (P<.001). Postoperatively, the torsional machine yielded less central corneal edema than the transversal (P<.001) and longitudinal (P=.04) machines, corresponding to a smaller increase in mean corneal thickness (torsional 5%, transversal 10%, longitudinal 12%; P=.04). Also, the torsional machine had better 1-day postoperative visual acuities (P<.001).

CONCLUSIONS:

All 3 phacoemulsification machines were effective with no significant intraoperative complications. The torsional machine outperformed the transversal and longitudinal machines, with a lower mean needle time, less chatter, and improved followability. This corresponded to less corneal edema 1 day postoperatively and better visual acuity.

• Authors: Panos G Christakis, Rosa M Braga-Mele
• Journal: Journal of cataract and refractive surgery (J Cataract Refract Surg) Vol. 38 Issue 2 Pg. 234-41 (Feb 2012) ISSN: 1873-4502 [Electronic] United States
• PMID: 22153315 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Chemical References

• Viscosupplements

Topics

• Aged
• Corneal Edema (physiopathology, prevention & control)
• Female
• Humans
• Intraoperative Complications
• Lens Implantation, Intraocular
• Male
• Phacoemulsification (instrumentation)
• Postoperative Complications
• Pseudophakia (physiopathology)
• Retrospective Studies
• Treatment Outcome
• Viscosupplements (administration & dosage)
• Visual Acuity (physiology)