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So-Hyang Chung, MD, PhD, Choun-Ki Joo, MD, PhD

So-Hyang Chung, MD, PhD, Choun-Ki Joo, MD, PhD Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea. Comparison of clinical outcomes of torsional handpiece through micro incision and standard clear corneal incision.

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So-Hyang Chung, MD, PhD, Choun-Ki Joo, MD, PhD

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  1. So-Hyang Chung, MD, PhD, Choun-Ki Joo, MD, PhD Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea Comparison of clinical outcomes of torsionalhandpiece through micro incision and standard clear corneal incision * Authors have no financial interests.

  2. Introduction • Reduction of incision size • Decreased energy and increased efficiency • Less endothelial cell loss *Advancement of Cataract surgery technique * OZiLtorsionalhandpiece > traditional handpiece Reduce the amount of phacoemulsification energy Increase efficiency Allow cataract surgery through micro coaxial incision.

  3. Purpose 2.2mm micro coaxial incision (32 eyes) 0.9mm mini-flared 45- degree bevel Kelman ABS tip 2.8mm Standard clear corneal incision (28 eyes) 0.9mm micro 45 degree bevel Kelman ABS tip Versus • Our study was designed to compare torsional ultrasound systems with same degree tips between standard 2.8 mm standard clear corneal incisions and 2.2 mm micro coaxial incisions.

  4. Methods ethod • Retrospective study • Duration : April 2008 ~ September 2008 • Patients : 60 eyes patients • Operated by one surgeon • Cataracts of similar density (LOCS III classification –grade III, IV) Exclusion criteria 1. Underlying systemic disease or ocular disease (DM, Corneal surface irregularity, high myopia, RD, glaucoma) 2. Age > 80yrs

  5. 6 5 Suturelesstechnique In the bag IOL implantation 4 3 Phacoemuls-ification 2 About 6.0mm CCC diameter 1 Temporal clear corneal incision patients selection Methods • Parameters • Intra-operative parameters • Meancumulative dissipated energy (CDE) • Total balanced salt solutions (BSS) • Post-operative parameters • Central corneal thickness (CCT) atpostoperative 1 day • Endothelial cell loss (ECL) at postoperative 6 months All cases were uncomplicated.

  6. Results Intra-operative and post-operative characters. • Paired T-test • P<0.05

  7. CDE showed positive correlation with BSS use • (P<0.001, R2=0.302). 2.2 mm micro coaxial incision 2.8 mm standard incision

  8. 2.2mm group 2.8mm group • CDE showed positive correlation with ECL and CCT change (P=0.006, R2=0.345, P=0.22, R2=0.346).

  9. BSS useshowed positive correlation with ECL • (P=0.012, R2=0.283). 2.2 mm micro coaxial incision 2.8 mm standard incision

  10. Discussion • CDE and endothelial cell loss were lower in the micro coaxial incision group (P<0.05).  Better cutting efficiency with a mini-flared 45-degree tip may reflect its better holding force factor of a mini-flared 45-degree tip in micro coaxial incision. • Postoperative endothelial cells loss correlated with intra-operative CDE and BSS use.

  11. Discussion • Phacoemulsification (using the OZiltorsionalhandpiece) through 2.2 mm micro coaxial incisions showed less total energy use and less endothelial cell loss than 2.8 mm standard incisions. • Torsional ultrasound systems through 2.2 mm micro coaxial incisions were safe and effective in phacoemulsification!

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