title: The comparison between torsional and conventional mode phacoemulsification in moderate and hard cataracts.
abstract: OBJECTIVE
  To compare the intraoperative performances and postoperative outcomes of cataract surgery performed with longitudinal phacoemulsification and torsional phacoemulsification in moderate and hard cataracts.
  
  
  METHODS
  Of 85 patients who had senile cataracts, 102 eyes were operated on using the Infiniti Vision System. Preoperative examinations (slit lamp examination, mean central corneal thickness, and central endothelial cell counts) were performed for each patient. Cataracts were subdivided into moderate and hard, according to the Lens Opacities Classification System III grading of nucleus opalescence (NO). Eyes in each cataract group were randomly assigned to conventional and torsional phaco-mode. Intraoperative parameters, including ultrasound time (UST), cumulative dissipated energy (CDE), and the balanced salt solution plus (BSSP) volume utilized were evaluated. Best corrected visual acuity (BCVA) was checked on postoperative day 30; mean central corneal thickness and central endothelial cell counts were investigated on postoperative days 7 and 30.
  
  
  RESULTS
  Preoperative BCVA and mean grading of NO showed no difference in both groups. Preoperative endothelial cell count and central corneal thickness also showed no significant difference in both groups. In the moderate cataract group, the CDE, UST, and BSSP volume were significantly lower in the torsional mode than the longitudinal mode, but they did not show any difference in the hard cataract group. Torsional group showed less endothelial cell loss and central corneal thickening at postoperative day seven in moderate cataracts but showed no significant differences, as compared with the longitudinal group, by postoperative day 30.
  
  
  CONCLUSIONS
  Torsional phacoemulsification showed superior efficiency for moderate cataracts, as compared with longitudinal phacoemulsification, in the early postoperative stage.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dong-Hyun
authors.initials: DH
authors.lastname: Kim
authors.forename: Won-Ryang
authors.initials: WR
authors.lastname: Wee
authors.forename: Jin-Hak
authors.initials: JH
authors.lastname: Lee
authors.forename: Mee-Kum
authors.initials: MK
authors.lastname: Kim
mesh_terms: D000368:Aged; D002386:Cataract / Q000145:classification* / Q000473:pathology*; D002387:Cataract Extraction / Q000379:methods*; D002452:Cell Count; D003315:Cornea / Q000000981:diagnostic imaging; D004728:Endothelium, Corneal / Q000473:pathology; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011184:Postoperative Period; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014792:Visual Acuity