corneal endothelial cell parameters after torsional versus conventional ultrasound mode phacoemulsification

purpose: to compare corneal endothelial cell features after cataract surgery performed using fixed torsional or conventional (pulse) ultrasound mode. methods: in this randomized comparative study, 60 eyes were randomly and equally divided into two groups of torsional or longitudinal mode phacoemulsification. all surgeries were performed by an experienced surgeon, and the outcomes were evaluated by a masked examiner. preoperatively visual acuity (va), age and mean nuclear grade (locs iii) were recorded; besides automated confocal microscopy was used to measure ecd, polymegathism and pleomorphism at the centre of the cornea. all patients underwent clear cornea phacoemulsification in a similar manner. intraoperative outcome measures were ultrasound time (ust), cumulative dissipated energy (cde), and total fluid use. best corrected va and confocal measurements were repeated after 1 month. results: mean preoperative ecd in conventional and torsional phaco mode groups were 2761.61 ± 403.36 and 2690.36 ± 490.92 cells/mm2. postoperative ecd was 2494.30 ± 358.63 and 2436.56 ± 468.39 cells/mm2, respectively. the decrease in ecd, and increase in pleomorphism and polymegatism were statistically significant within both study groups (p<.001), but there were no statistically significant differences in preoperative and postoperative measurements between the 2 groups (p>.01). no relevant clinical differences or operative complications were seen in either group. there were no statistically significant difference between intraoperative measures in both groups (p>.01). conclusion: both phaco methods provide effective lens removal with no significant difference.