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Prospective Study Comparing Outcomes of Torsional versus Traditional Phacoemulsification Systems on Dense Cataracts

Prospective Study Comparing Outcomes of Torsional versus Traditional Phacoemulsification Systems on Dense Cataracts . Bonnie An Henderson MD, Kelly J Grimes MS Ophthalmic Consultants of Boston Harvard Medical School Financial Disclosure Henderson: Alcon labs- grant support, speaker’s bureau

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Prospective Study Comparing Outcomes of Torsional versus Traditional Phacoemulsification Systems on Dense Cataracts

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  1. Prospective Study Comparing Outcomes of Torsional versus Traditional Phacoemulsification Systems on Dense Cataracts Bonnie An Henderson MD, Kelly J Grimes MS Ophthalmic Consultants of Boston Harvard Medical School Financial Disclosure Henderson: Alcon labs- grant support, speaker’s bureau ISTA pharmaceuticals- grant support Grimes: None

  2. Purpose • To compare the post-operative surgical outcomes of torsional (Alcon Infiniti™ Ozil) and traditional (Bausch and Lomb Millennium™) phacoemulsification systems on different grades of cataracts

  3. Methods • Preoperatively: • Patients’ standard preoperative examination and measurements were recorded. • Additionally, preoperative central corneal pachymetry was recorded. • All cataracts were graded by the LOCS classification by one examiner (BAH) • Only cataracts that were NO4NC4 or higher were considered “dense” and included in the subgroup

  4. Methods • Patients were randomized to receive cataract surgery using either the Alcon Infiniti™ OZil machine or the B&L Millennium™ machine. • Surgical technique, instruments, type of viscoelastic, and type of IOL were held constant for all surgeries in the study

  5. Methods • Intraoperatively: • total surgical time, phaco time, ultrasound time and energy, total BSS, phaco BSS were recorded • Patients with previous corneal disease were excluded from the study • Patients with an IOP > 26 on postoperative day 1 were excluded from analysis (due to effect of high IOP and causal relationship to corneal edema)

  6. Methods • Patients were followed up at one day, one week, and one month post-operatively. • Recorded at each visit: • vision, intraocular pressure • corneal thickness • anterior chamber inflammation • corneal edema • All patients received the same type and quantity of postoperative drops • Data was analyzed in two groups: 1) all lens densities 2) a sub-group of dense lens cataract patients (NO4, NC4 or denser).

  7. Results • 127 patients (69 B & L, 58 Alcon) • 36 dense lens patients (21 B & L, 15 Alcon) • 6 patients excluded due to IOP > 26 on postoperative day 1

  8. Results – All Cases * numerical values represent physician's quantitative estimation of corneal edema/anterior chamber inflammation respectively as follows: NL = 0, rare/trace = 1, occasional = 2, 0.5 = 3, 1+ = 4, 2+ = 5, 3+ = 6, 4+ =7

  9. Results – Dense Lens Cases * numerical values represent physician's quantitative estimation of corneal edema/anterior chamber inflammation respectively as follows: NL = 0, rare/trace = 1, occasional = 2, 0.5 = 3, 1+ = 4, 2+ = 5, 3+ = 6, 4+ =7

  10. Results – Dense Lens Cases * numerical values represent physician's quantitative estimation of corneal edema/anterior chamber inflammation respectively as follows: NL = 0, rare/trace = 1, occasional = 2, 0.5 = 3, 1+ = 4, 2+ = 5, 3+ = 6, 4+ =7

  11. Conclusions • Phacoemulsification cataract extraction on all lens types by torsional energy (Alcon Infiniti™ Ozil) resulted in significantly less corneal edema and thickness on post op day one compared to surgery by traditional ultrasound energy. • There was significantly less corneal edema and anterior chamber inflammation at one week postoperatively with the torsional energy system.

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