title: Endothelial cell loss: Biaxial small-incision torsional phacoemulsification versus biaxial small-incision longitudinal phacoemulsification.
abstract: OBJECTIVE
  To compare clinical results of biaxial small-incision torsional phacoemulsification and biaxial small-incision longitudinal phacoemulsification.
  
  
  METHODS
  Department of Ophthalmology, School of Medicine, Namik Kemal University, Tekirdag, Turkey.
  
  
  METHODS
  Randomized controlled clinical trial.
  
  
  METHODS
  Eyes with high-density nuclear cataract were assigned to have biaxial longitudinal (microburst mode) or biaxial torsional phacoemulsification. The main outcomes included corrected distance visual acuity (CDVA), central corneal thickness (CCT), central endothelial cell density (ECD), total ultrasound time (UST), cumulative dissipated energy (CDE), percentage total equivalent power in position 3, and balanced salt solution volume. Postoperative follow-up was at 1 day, 1 week, and 1 and 3 months.
  
  
  RESULTS
  Each group comprised 35 patients (35 eyes). Three months postoperatively, the mean CDVA for each group was 0.02 logMAR and the mean CCT returned to the preoperative level (P=.589 and P=.554, respectively). During the postoperative follow-up, the percentage of mean endothelial cell loss in both groups was between 35.4% and 39.1%; there was no statistically significant difference between the groups (P>.05). The mean CDE, UST, percentage total equivalent power in position 3, and balanced salt solution volume values were similar in the 2 groups (P>.05).
  
  
  CONCLUSIONS
  The risk for high endothelial cell loss should be considered when the phacoemulsification of high-density nuclear cataracts is performed using either method.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Namik Kemal University, School of Medicine, Department of Ophthalmology, Tekirdag, Turkey. tansugonen@yahoo.com
authors.forename: Tansu
authors.initials: T
authors.lastname: Gonen
authors.forename: Ozkan
authors.initials: O
authors.lastname: Sever
authors.forename: Fatih
authors.initials: F
authors.lastname: Horozoglu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yasar
authors.forename: Kadircan H
authors.initials: KH
authors.lastname: Keskinbora
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000145:classification / Q000473:pathology; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis / Q000209:etiology*; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications; D011446:Prospective Studies; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology