Clinical Outcomes of Cataract Surgery Using Torsional Mode Phacoemulsification and Soft Shell Technique

Tae-Hoon Oh; Seung-Jin Lee; Hyun Seung Kim

doi:10.3341/jkos.2009.50.9.1313

Journal List > J Korean Ophthalmol Soc > v.50(9) > 1008355

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Oh, Lee, and Kim: Clinical Outcomes of Cataract Surgery Using Torsional Mode Phacoemulsification and Soft Shell Technique

Original Article

J Korean Ophthalmol Soc 2009;50(9):1313-1318.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.9.1313

Clinical Outcomes of Cataract Surgery Using Torsional Mode Phacoemulsification and Soft Shell Technique

Tae-Hoon Oh, MD, Seung-Jin Lee, MD, Hyun Seung Kim, MD, PhD

Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, St. Mary's Hospital, Seoul, Korea

Address reprint requests to Hyun Seung Kim, MD, PhD Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, St. Mary's Hospital #62 Yeouido-dong, Yeongdeungpo-gu, Seoul 150-713, Korea Tel: 82-2-3779-1243, Fax: 82-2-761-6869, E-mail: sara514@catholic.ac.kr

Received 9 December 2008 Accepted 2 June 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the additional protective effect of the soft shell technique on corneal endothelial cells in torsional mode phacoemulsification.

Methods

Torsional mode phacoemulsification was performed on 60 eyes in 38 patients who were diagnosed with moderate cataracts. Thirty eyes were assigned to the soft shell technique group, and a control group with 30 eyes using only cohesive viscoelastics was created to evaluate ultrasound (US) time, mean US intensity, cumulative dissipated energy (CDE), and amount of used balanced salt solution. Corneal endothelium and corneal thickness were measured before and after the procedure.

Results

There were no statistically significant differences in US time, mean US intensity, cumulative dissipated energy, and dosage of the balanced salt solution between the two groups. There were no statistically significant differences between the two groups in postoperative central corneal thickness. Corneal endothelial cell densities decreased significantly after surgery in both groups, but there were no statistically significant differences between the two groups.

Conclusions

There are no significant differences in the intensity of ultrasound, the density of corneal endothelial cells or the thickness of the cornea between the two groups. Therefore, the soft shell technique is not needed under torsional mode phacoemulsification.

Keywords: Phacoemulsification, Soft shell technique, Torsional mode

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Figure 1.

Sequential changes of central cornea thickness (μm) in the soft shell technique and control group after cataract surgery.

Figure 2.

Sequential changes of endothelial cell density (cells/mm²) in the soft shell technique and control group after cataract surgery.

Table 1.

Intraoperative characteristics of the parameters

	Soft shell technique group	Conventional group	p value
Mean BSS^† volume (mL)	61.4±16.72	55.0±19.35	0.17
Mean Phaco time (sec)	33.58±15.82	30.16±20.18	0.46
Mean Phaco power (%)	32.19±17.08	32.48±20.87	0.85
CDE^∗	3.97±2.13	3.68±2.98	0.67

^∗ CDE=cumulative dissipated energy=torsional amplitude× torsional time×0.4;

^† BSS=BSS Plus^®, Alcon, Fort Worth, TX, USA.

Table 2.

Correlation between phacoemulsification parameter and decrement of endothelial cells

	Correlation coefficient (p value)
	Soft shell technique group	Conventional group
Mean BSS volume(ml)	0.150 (0.40)	0.055 (0.77)
Mean Phaco time(sec)	0.171 (0.36)	0.027 (0.08)
Mean Phaco power(%)	0.197 (0.29)	0.020 (0.91)
CDE^∗	0.088 (0.64)	0.033 (0.86)

^∗ CDE=cumulative dissipated energy=torsional amplitude× torsional time×0.4.

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