Comparative analysis of corneal morphological changes after transversal and torsional phacoemulsification through 2.2 mm cornel incision

Purpose: This paper compares and evaluates the corneal morphological changes occurring after cataract surgery through a 2.2 mm corneal incision. We use two platforms for comparison and evaluation, transversal and torsional phacoemulsification. Patients and methods: This study includes 139 consecutive cataractous eyes ( nuclear color 2-4, according to the Lens Opacities Classification System III [LOCSIII]) of 82 patients undergoing cataract surgery through a 2.2 mm' corneal incision. Two different phacoemulsification platforms were used and assigned randomly: we used the WhiteStar Signature ((R)) system with the Ellips (TM) FX transversal continuous ultrasound (US) mode for group I (mean age: 65.33 +/- 6.97 years), and we used the Infiniti ((R)) system with the OZil ((R)) Intelligent Phaco (IP) torsional US mode for group II (mean age: 64.02 +/- 7.55 years). The corneal endothelium and pachymetry were evaluated preoperatively and at 1 month postoperatively. Incision size changes were also evaluated. Results: All surgeries were uneventful. Before intraocular lens implantation, the mean incision size was 2.24 +/- 0.06 mm in both groups (P=.75). In terms of corneal endothelial cell density, neither preoperative ( I vs II: 2304.1 +/- 122.5 cell/mm(2) vs 2315.6 +/- 83.1 cell/mm(2), P +/- 0.80) nor postoperative (I vs II: 2264.1 +/- 124.3 cell/mm(2) vs 2270.3 +/- 89.9 cell/mm(2), P +/- 0.98) differences between the groups were statistically significant. The mean endothelial cell density loss was 1.7% +/- 1.6% and 2.0%+/- 1.4% in groups I and II, respectively. Furthermore, no significant differences between groups I and II were found preoperatively (P=0) and postoperatively (P=.68) in central pachymetry. With surgery, the mean increase in central pachymetry was 28.1 +/- 23.6 mu m and 24.0 +/- 24.0 mu m in groups I and II, respectively (P=0.1). Conclusion: Ellips (TM) FX transversal and OZil ((R)) IP torsional phacoemulsification modes are safe for performing cataract surgery, inducing minimal corneal thickness and endothelial changes.