Efficacy of Torsional Phaco in Hard Egyptian Cataract Versus Combined Torsional and Longitudinal Phaco Using the Infiniti Vision System

Purpose: To compare the efficacy and phacoemulsification parameters of torsional mode versus the combined torsional and longitudinal ultrasound mode in hard cataract of Egyptian patients. Methods: This randomized comparative study evaluated eyes 1, 7, and 30 days after phacoemulsification with an Infiniti Vision System using the torsional mode versus the combined torsional (100%) and longitudinal ultrasound (US) mode (20%). Egyptian patients with nucleus grade ranging from NO4/NC4 to NO5/NC5 were selected. Nucleus fragmentation was done by the stop and chop method. Primary outcome measures were phaco time, mean phaco power, mean torsional amplitude, amount of infused fluid, cumulative dissipated energy (CDE) and total energy. Results: 42 eyes of 42 patients divided randomly into two groups were evaluated. There is no statistical difference between the torsional mode and the combined torsional and longitudinal ultrasound (US) mode as regarding the phacoemulsification parameters, although they were lower in the combined mode. No complications were recorded among both groups. Conclusions: Torsional mode alone can be used for emulsification of very hard cataract with no added risks or complications.