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Comparison of clear corneal incision injuries between torsional and conventional phacoemulsification

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Abstract

Purpose

To compare thermal and mechanical clear corneal incision (CCI) injuries after conventional and torsional phacoemulsification.

Design

A prospective, randomized clinical study.

Methods

A total of 80 eyes were evaluated for the profile of the incision at 1 day and 3 months postoperatively. The wound architecture was recorded with anterior segment optical coherence tomography (AS-OCT). The incisional thickness increased by thermal injury, Descemet’s membrane detachment (DMD) caused by mechanical injury, the presence of endothelial gaping, loss of coaptation, and wound retraction of the conventional phaco group and the torsional phaco group were compared.

Results

The corneal thickness at the incision site of the torsional ultrasound group was significantly lower than the conventional group compared to at the first postoperative visit (1187.55 ± 75.66, 1233.62 ± 85.87, P = .013). However, this thickness was similar between the two groups at 3 months postoperatively. The central endothelial cell loss was significantly lower in the torsional ultrasound group after 3 months (417 ± 143, 322 ± 130, P = .003). There was a positive correlation between cumulated dissipated energy (CDE) and the incisional corneal thickness change that was observed by AS-OCT. Other OCT outcome parameters (such as endothelial gap, DMD, epithelial gap, and uncoaptation) that may be caused by mechanical injury did not differ significantly between the groups on postoperative day one or after 3 months.

Conclusions

The torsional ultrasound mode may provide a lower level of phacoemulsification time and energy and induce less incisional corneal thickness caused by thermal injury in the early postoperative period. The long-term wound healing appeared the same in both ultrasound mode groups.

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No author has a financial or proprietary interest in any material or method mentioned in this article.

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Authors and Affiliations

  1. Department of Ophthalmology, Zhongshan Hospital of Fudan University, Shanghai, China

    Xu Chen

  2. Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China

    Yinghong Ji & Yi Lu

Authors
  1. Xu Chen
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  2. Yinghong Ji
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  3. Yi Lu
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Corresponding author

Correspondence to Yi Lu.

Additional information

Xu Chen and Yinghong Ji authors contributed equally to this work.

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Chen, X., Ji, Y. & Lu, Y. Comparison of clear corneal incision injuries between torsional and conventional phacoemulsification. Graefes Arch Clin Exp Ophthalmol 251, 2147–2154 (2013). https://doi.org/10.1007/s00417-013-2423-3

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  • DOI: https://doi.org/10.1007/s00417-013-2423-3

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