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[Effectivity and Safety of a Modified Tip Design in Torsional Phacoemulsification].

Authors: Sabine, Schmidt; Sophie, Hubich; Jan Markus, Vetter; Christopher, Wirbelauer;

[Effectivity and Safety of a Modified Tip Design in Torsional Phacoemulsification].

Abstract

Torsional mode phacoemulsification results in more effective fragmentation of the nucleus due to a different movement of the phacotip. In this clinical study, we investigated the influence of a modified tip design and active fluidics on the efficacy of phacoemulsification and safety for the corneal endothelium.We conducted a prospective randomized 2 : 1 study in which 40 patients were operated on with the mini-flared Kelman Tip using the Infiniti® System (group 1), and 20 patients were operated on with the Intrepid® Balanced Tip and the Centurion® System. We analyzed the intraoperative cumulative dissipated energy and also the density of the corneal endothelium measured with an endothelial microscope (CEM 530, Nidek) pre- and postoperatively.Both groups did not differ preoperatively in age, sex, axial length of the globe or corneal endothelium cell density nor cataract density (LOCS3). All surgeries were uneventful. The cumulative dissipated energy in group 1 (mini-flared Kelman tip, Infiniti System) was 38% higher than in group 2 (balanced tip, Centurion System; p  0.05). The cell size (polymegathism) increased in both groups significantly with + 37 µm in group 1 (p  0.05). The number of hexagonal cells (pleomorphism) and corneal thickness did not differ in both groups either pre- nor postoperatively.Compared to torsional phacoemulsification with a mini-flared Kelman Tip and gravity fluidics, torsional phacoemulsification with a modified tip design and active fluidics is 38% more effective regarding the cumulative dissipated energy. Endothelial cell loss occurs to a similar extend using both systems. The postoperative changes in cell size (polymegathism), number of hexagonal cells (pleomorphism) and corneal thickness (pachymetry) were similar among both systems. We conclude, that the intraoperative stress on the endothelium is equivalent with both systems used.

Keywords

Phacoemulsification, Endothelium, Corneal, Visual Acuity, Humans, Cell Count, Cataract Extraction, Prospective Studies, Ophthalmic Solutions, Therapeutic Irrigation

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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