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Comparison of torsional and longitudinal modes using phacoemulsification parameters

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TLDR
Torsional phacoemulsification was more effective than longitudinal phacoEmulsification in the amount of applied fluid and the quantity of US energy expended and with the torsional method, it was possible to maintain a constant ratio of amount of fluid flow to quantity ofUS energy used, regardless of nucleus density.
Abstract
Purpose To compare phacoemulsification parameters of torsional and longitudinal ultrasound modes. Setting Ophthalmology Department, Military Health Service Institute, Warsaw, Poland. Methods This prospective study evaluated eyes 1, 7, and 30 days after phacoemulsification with an Infiniti Vision System using the torsional or longitudinal ultrasound (US) mode. Cataract classification was according to the Lens Opacities Classification System II. Nucleus fragmentation was by the phaco-chop and quick-chop methods. Primary outcome measures were phaco time, mean phaco power, mean torsional amplitude, and aspiration time. Total energy, defined as cumulative dissipated energy (CDE) × aspiration time, and the effective coefficient, defined as aspiration time/phaco time, were also calculated. Results Four hundred eyes were evaluated. The CDE was statistically significantly lower in the torsional mode for nucleus grades I, II, and III (P .05). Aspiration time was statistically significantly shorter in the torsional mode than in the longitudinal mode for nucleus grades III and IV (P Conclusions Torsional phacoemulsification was more effective than longitudinal phacoemulsification in the amount of applied fluid and the quantity of US energy expended. With the torsional method, it was possible to maintain a constant ratio of amount of fluid flow to quantity of US energy used, regardless of nucleus density.

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Citations
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Corneal endothelial morphology and function after torsional and longitudinal ultrasound mode phacoemulsification.

TL;DR: Both phacoemulsification techniques were safe and effective and the torsional handpiece performs oscillatory movements and delivers less energy into the eye than the longitudinal ultrasound technique, therefore providing more favorable energy and thermal safety profile.
Journal ArticleDOI

Comparison of Clinical Outcomes between Torsional and Longitudinal Phacoemulsification.

TL;DR: In mild and moderate cataracts, the efficiency of phaco and corneal changes were similar between the 2 modalities, however, recently improved longitudinal phaco showed superior efficiency for hard cataract and induced less endothelial cell loss than torsional phaco.
References
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Journal ArticleDOI

Lens Opacities Classification System II (LOCS II)

TL;DR: Very good interobserver reproducibility of the clinical gradings at the slit lamp, excellent intraobserver reproducecibility, very good to excellent interob server reproducible of photographic gradings, and good agreement between clinical and photographic grading are obtained.
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Endothelial cell loss after phacoemulsification: relation to preoperative and intraoperative parameters

TL;DR: The location of corneoscleral incisions for phacoemulsification can be chosen according to the preoperative astigmatism without inducing additional adverse effects on the corneal endothelium.
Journal ArticleDOI

Torsional mode versus conventional ultrasound mode phacoemulsification: Randomized comparative clinical study

TL;DR: The torsional mode may provide more effective lens removal with a lower level of phacoemulsification time and energy.
Journal ArticleDOI

New phacoemulsification technology.

TL;DR: Continual advances in phacoemulsification technology and adjunctive surgical devices allow cataract surgery to be performed more safely and efficiently.
Journal ArticleDOI

The physics of phaco: A review

TL;DR: It is concluded that phacoemulsification most likely operates by a combination of mechanisms, including direct action of the vibrating tip against tissue and indirect cavitational effects.
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