title: Comparison of 45-degree Kelman and 45-degree balanced phaco tip designs in torsional microcoaxial phacoemulsification.
abstract: OBJECTIVE
  To compare the intraoperative performance and postoperative outcome after microcoaxial torsional phacoemulsification using either a Kelman or balanced phaco tip.
  
  
  METHODS
  Cataracts were treated using 2.2 mm microcoaxial torsional phacoemulsification using either a 45-degree mini-flared Kelman(®) or a 45-degree Intrepid(®) Balanced phaco tip. Intraoperative measurements included total ultrasound (US) time, cumulative dissipated energy (CDE), torsional US time, and balanced salt solution (BSS) use. The central endothelial cell density (ECD) and central corneal thickness (CCT) were evaluated preoperatively and postoperatively 1, 7, and 30d after surgery using noncontact specular microscopy.
  
  
  RESULTS
  The 116 enrolled eyes (116 patients) were divided equally between the Kelman and balanced tip groups. Intraoperative measurements showed significantly less total US time, torsional US time, CDE, and BSS use in the balanced group than in Kelman group (P<0.05). The total US time, torsional US time, CDE, and BSS use were 17.45±14.53s, 16.63±13.97s, 6.38±5.26, and 48.21±17.21 mL in the Kelman group and 11.39 ± 9.60s, 10.90 ± 9.25s, 4.04 ± 3.42, and 41.36 ± 12.70 mL in the balanced group, respectively.
  
  
  CONCLUSIONS
  Torsional phacoemulsification performed with a balanced tip provided more effective lens removal with less total US time, torsional time, CDE, and BSS use, as well as similar changes in ECD with a Kelman tip in all cataract grades. This special designed phaco tip for torsional phacoemulsification provides an alternative phaco tip for many surgeons' preference with straight phaco tip.
authors.affiliation: Eye Clinic, Kayseri Training and Research Hospital, Kayseri 38010,Turkey.
authors.forename: Süleyman
authors.initials: S
authors.lastname: Demircan
authors.affiliation: Eye Clinic, Kayseri Training and Research Hospital, Kayseri 38010,Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ataş
authors.affiliation: Eye Clinic, Kayseri Training and Research Hospital, Kayseri 38010,Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Göktaş
authors.affiliation: Eye Clinic, Kayseri Training and Research Hospital, Kayseri 38010,Turkey.
authors.forename: Burhan
authors.initials: B
authors.lastname: Başkan
keywords: Kelman phaco tip; balanced phaco tip; phaco tip; torsional phacoemulsification