Torsional ultrasound modality for hard nucleus phacoemulsification cataract extraction

Zeng, Mingbing; Liu, X; Liu, Y; Xia, Yuanlin; Luo, Lixia; Yuan, Zhihang; Zeng, Yonghong

doi:10.1136/bjo.2007.128504

Cited by 65 publications

(87 citation statements)

References 22 publications

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“…The result showed no statistically significant postoperative ECD decrease in the center. This can be attributed to the low CDE value used compared to the previous torsional phacoemulsification studies [2,3,[30][31][32]. We enrolled patients with moderate cataracts, and the surgery was performed with the phaco-chop technique using dispersive OVD to minimize CDE and endotheilal cell damage.…”

Section: Discussionmentioning

confidence: 99%

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The pattern of early corneal endothelial cell recovery following cataract surgery: cellular migration or enlargement?

Kim

Wee

Hyon

2015

Graefes Arch Clin Exp Ophthalmol

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Section: Discussionmentioning

confidence: 99%

“…A lot of studies have examined the changes of endothelial cell density (ECD) in a central cornea after cataract surgery up to now [1][2][3][4]. It is widely known that damage to corneal endothelium is recovered by cellular migration and enlargement [5].…”

Section: Introductionmentioning

confidence: 99%

The pattern of early corneal endothelial cell recovery following cataract surgery: cellular migration or enlargement?

Kim

Wee

Hyon

2015

Graefes Arch Clin Exp Ophthalmol

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“…Zeng et al 16 compared torsional US with longitudinal US in eyes with hard nucleus cataract. They reported an SD of 12 μm in the difference between preoperative and postoperative corneal thickness measurements in both groups.…”

Section: Discussionmentioning

confidence: 99%

“…They reported a significantly lower use of US power and cumulative dissipated energy (CDE), smaller increases of CCT 1 and 7 days postoperatively, faster visual recovery, and less endothelial cell loss in the torsional group. [15][16][17] To our knowledge, there are no studies comparing these 2 phacoemulsification modes in patients with FED, who might benefit the most from a reduction in endothelial cell damage. The purpose of this study was to compare corneal thickness and corneal volume (CV) changes using torsional and longitudinal phacoemulsification in patients with FED and determine preoperative and intraoperative risk factors for corneal decompensation after phacoemulsification.…”

mentioning

confidence: 99%

Phacopower Modulation and the Risk for Postoperative Corneal Decompensation

Doors¹,

Berendschot²,

Touwslager³

et al. 2013

JAMA Ophthalmol

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In compromised corneas, eg, patients with Fuchs endothelial dystrophy (FED), it is of utmost importance to use a phacotechnique that is the least traumatic to the corneal endothelium. Furthermore, preoperative patient selection is crucial, because unexpected corneal decompensation leads to dissatisfied patients.OBJECTIVE To compare corneal thickness and corneal volume changes using torsional and longitudinal phacoemulsification in patients with Fuchs endothelial dystrophy (FED) and determine risk factors of postoperative corneal decompensation. DESIGN, SETTING, AND PARTICIPANTSProspective randomized clinical trial of all patients diagnosed with FED and planning to undergo cataract surgery for visually significant cataract at a university medical center from November 2008 to May 2010.INTERVENTION Fifty-two eyes with FED and visually significant cataract underwent torsional (n = 26) or longitudinal (n = 26) phacoemulsification. Patients were evaluated preoperatively and 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively. Visits included best spectacle-corrected visual acuity, anterior segment optical coherence tomography evaluating central corneal thickness (CCT) and peripheral corneal thickness (PCT), and Scheimpflug imaging calculating corneal volume (CV). Randomization took place according to stage of FED, nucleus density grade, and age. Intraoperatively, ultrasonography time and cumulative dissipated energy were recorded. MAIN OUTCOMES AND MEASURES Central corneal thickness, PCT, and CV.RESULTS Ultrasonography time and cumulative dissipated energy were significantly lower in the torsional group for harder nucleus density grades compared with the longitudinal group (P = .009 and P = .002, respectively). Peripheral corneal thickness at the 6-o'clock position, CCT, and CV were significantly smaller in the torsional group 1 day postoperatively (P = .002; P = .03; and P = .004, respectively). Changes in PCT at the 12-o'clock position and best spectacle-corrected visual acuity were not significantly different between the 2 groups (P > .05). Preoperative CCT was the only significant predictor of corneal decompensation postoperatively (P < .001). Preoperative CCT of 620 μm corresponded to an odds ratio of 1, meaning no increased risk of developing corneal decompensation. For each 10-μm increase in preoperative CCT, the odds of developing corneal decompensation increased 1.7 times.CONCLUSIONS AND RELEVANCE Torsional phacoemulsification effectively reduces ultrasonography time and cumulative dissipated energy compared with longitudinal phacoemulsification in patients with FED. However, there were only significant differences in corneal thickness and CV changes at 1 day postoperatively in favor of the torsional group. Central corneal thickness more than 620 μm, measured by noncontact pachymetry, leads to an increased risk for corneal decompensation after phacoemulsification in patients with FED.TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00781027

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“…Both these drawbacks are overcome by the torsional movement. 46 Transversal ultrasound is another modification wherein the longitudinal movement of the tip of the phacoemulsifier is combined with transverse movement giving rise to an elliptical motion.…”

Section: Torsional and Transversal Ultrasoundmentioning

confidence: 99%

Advances in cataract surgery

Ashwin

Shah

Wolffsohn

2009

Clinical and Experimental Optometry

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Cataract surgery is a technique described since recorded history, yet it has greatly evolved only in the latter half of the past century. The development of the intraocular lens and phacoemulsification as a technique for cataract removal could be considered as the two most significant strides that have been made in this surgical field. This review takes a comprehensive look at all aspects of cataract surgery, starting from patient selection through the process of consent, anaesthesia, biometry, lens power calculation, refractive targeting, phacoemulsification, choice of intraocular lens and management of complications, such as posterior capsular opacification, as well as future developments. As the most common ophthalmic surgery and with the expanding range of intraocular lens options, optometrists have an important and growing role in managing patients with cataract.

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Torsional ultrasound modality for hard nucleus phacoemulsification cataract extraction

Cited by 65 publications

References 22 publications

The pattern of early corneal endothelial cell recovery following cataract surgery: cellular migration or enlargement?

The pattern of early corneal endothelial cell recovery following cataract surgery: cellular migration or enlargement?

Phacopower Modulation and the Risk for Postoperative Corneal Decompensation

Advances in cataract surgery

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