PP305 : torsional vs longitudinal phaco: protection of endothelium, myth or fact?

Dr.SHIBASHIS DAS

Aim: To compare the corneal endothelial cell changes following torsional and longitudinal phaco in various grades of cataracts.

Methods: Prospective randomized study including 300 patients. Group 1 (longitudinal,150) and group 2 (torsional,150). Nuclear sclerosis grade 1,2 and 3 (LOCS III classification) with dilated pupil were included. Complicated cataracts or those with high risk were excluded. One surgeon operated by phaco chop technique with the same two phaco machines. Patients were followed up for a period of 3 months.

Results: Average total phaco time in group 1 (NS1 22.2s, NSs2 47.4s,NS3 1.03 min) and that in group 2 (NS1 19.1s,NS2 30.8s, NS3 48.2s). Corneal endothelial cell in group 1 and 2 were 178.2 & 170.5,higher average with higher ns grade. Increase in CCT in group 1 and 2 were 3.5 and 3.9 u.

Conclusion: Torsional phaco had lower phaco mean time and damage to the endothelium than longitudinal phaco in higher grades of NS making it safe and efficient.