Comparison of endothelial changes and power settings between torsional and longitudinal phacoemulsification

PURPOSE To compare the intraoperative and postoperative outcomes of conventional longitudinal phacoemulsification and torsional phacoemulsification SETTING Department of Ophthalmology, University of Leipzig, Germany DESIGN Randomized single-center clinical trial METHODS Eyes with senile cataract were randomized to have phacoemulsification using the Infiniti Vision System and the torsional mode (OD) or conventional longitudinal mode Primary outcomes were corrected distance visual acuity (CDVA) and central endothelial cell density (ECD), calculated according to the Conference on Harmonisation-E9 Guidelines in which missing values were substituted by the median in each group (primary analysis) and the loss was then calculated using actual data (secondary analysis) Secondary outcomes were ultrasound (US) time cumulative dissipated energy (CDE), and percentage total equivalent power in position 3 Postoperative follow-up was at 3 months RESULTS The mean preoperative CDVA was 0 41 logMAR in the torsional group and 0 38 logMAR in the longitudinal group, improving to 0 07 logMAR postoperatively in both groups The mean ECD loss was 7 2% +/- 4 6% in the torsional group (72 patients) and 7 1% +/- 4 4% in the longitudinal group (76 patients), with no statistically significant differences in the primary analysis (P = 342) or secondary analysis (P = 906) The mean US time, CDE and percentage total equivalent power in position 3 were statistically significantly lower in the torsional group (98 patients) than in the longitudinal group (94 patients) (P< 001) CONCLUSION The torsional mode was as safe as the longitudinal mode in phacoemulsification for age-related cataract