title: Comparison of the effect of torsional and microburst longitudinal ultrasound on clear corneal incisions during phacoemulsification.
abstract: OBJECTIVE
  To compare incision integrity after clear corneal microcoaxial phacoemulsification using longitudinal and torsional ultrasound (US).
  
  
  METHODS
  Iladevi Cataract & IOL Research Centre, Ahmedabad, India.
  
  
  METHODS
  Prospective randomized experimental clinical trial.
  
  
  METHODS
  Part 1 comprised an experimental study of rabbit eyes. Group 1 received longitudinal US. Group 2 received torsional US. The right eye of each rabbit served as a control. Samples were processed for histomorphology and collagen I denaturation by immunofluorescence. Part 2 comprised a clinical trial of patients. Group 1 received torsional US. Group 2 received longitudinal US. At the end of surgery, trypan blue 0.0125% was instilled. After 2 minutes, 0.1 mL of aqueous was aspirated and its optical density measured.
  
  
  RESULTS
  In part 1, incision histomorphology was comparable in both modalities. Collagen denaturation tests (immunofluorescence, dot blot analysis) showed no irregularity in collagen arrangement in either group. In Group 2, Descemet membrane was detached and endothelial cells were minimal at the roof of the incision. In part 2, trypan blue ingress into the anterior chamber was significantly greater in Group 1 than in Group 2 (mean 3.40 + 0.6 log units versus and 3.77 + 0.82 log units) (P<.007).
  
  
  CONCLUSIONS
  Incision histomorphology in the torsional group showed minimal Descemet membrane detachment and minimal endothelial cell loss at the roof of the incision. Minimal ingress of trypan blue into the anterior chamber was observed with torsional US, indicating better wound integrity than with longitudinal US.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Iladevi Cataract & IOL Research Center, Raghudeep Eye Clinic, Memnagar, Ahmedabad, India. icirc@abhayvasavada.com
authors.forename: Abhay R
authors.initials: AR
authors.lastname: Vasavada
authors.forename: Vaishali
authors.initials: V
authors.lastname: Vasavada
authors.forename: Viraj A
authors.initials: VA
authors.lastname: Vasavada
authors.forename: Mamidipudi R
authors.initials: MR
authors.lastname: Praveen
authors.forename: S R Kaid
authors.initials: SR
authors.lastname: Johar
authors.forename: Devarshi
authors.initials: D
authors.lastname: Gajjar
authors.forename: Anshul I
authors.initials: AI
authors.lastname: Arora
mesh_terms: D000818:Animals; D001082:Aqueous Humor / Q000378:metabolism; D024042:Collagen Type I / Q000378:metabolism; D004396:Coloring Agents / Q000493:pharmacokinetics; D003315:Cornea / Q000000981:diagnostic imaging* / Q000601:surgery*; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis; D003886:Descemet Membrane / Q000473:pathology; D004311:Double-Blind Method; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D011817:Rabbits; D013524:Surgical Flaps / Q000473:pathology*; D014343:Trypan Blue / Q000493:pharmacokinetics; D014463:Ultrasonography; D014945:Wound Healing
chemical_list: D024042:Collagen Type I; D004396:Coloring Agents; D014343:Trypan Blue