Comparison of Clinical Outcomes between Torsional and Longitudinal Phacoemulsification

PURPOSE: To compare the clinical outcomes during phacoemulsification when using recently improved longitudinal (Stellaris(R), Bausch & Lomb, Rochester, NY, USA) and torsional (Infiniti Ozil(R), Alcon, Fort Worth, TX, USA) ultrasound. METHODS: The present study included 74 eyes of 59 patients undergoing cataract surgery. Operated eyes with mild cataract (nuclear sclerosis grade 1 and 2), moderate cataract (nuclear sclerosis grade 3) and hard cataract (nuclear sclerosis grade 4 and 5) were compared in terms of the total phacoemulsification (phaco) time, average phaco power, total phaco energy and amount of fluid used during cataract surgery between the 2 modalities. Endothelial cell density, corneal edema, central corneal thickness (CCT), surgically induced astigmatism (SIA) and best-corrected visual acuity (BCVA) were also evaluated preoperatively and up to 3 month postoperatively. RESULTS: In mild cataracts, the operative parameters and corneal changes were similar between the 2 modalities. In moderate cataracts, the total phaco time was significantly higher in the torsional group than the longitudinal group, but the average phaco power, total phaco energy, and amount of fluid were not significantly different. In patients with hard cataract, the torsional group showed higher total phaco time (27.50 +/- 17.77 sec vs. 97.08 +/- 12.67 sec), average phaco power, total phaco energy, persistent corneal edema at 1 week postoperatively and more endothelial cell loss at 3 month postoperatively (16.33 +/- 15.50% vs. 38.71 +/- 26.49%). Postoperative CCT, SIA and BCVA were not significantly different in hard cataracts between the 2 modalities. CONCLUSIONS: In mild and moderate cataracts, the efficiency of phaco and corneal changes were similar between the 2 modalities. However, recently improved longitudinal phaco showed superior efficiency for hard cataracts and induced less endothelial cell loss than torsional phaco.

Comparison of Clinical Outcomes between Torsional and Longitudinal Phacoemulsification

PURPOSE: To compare the clinical outcomes during phacoemulsification when using recently improved longitudinal (Stellaris(R), Bausch & Lomb, Rochester, NY, USA) and torsional (Infiniti Ozil(R), Alcon, Fort Worth, TX, USA) ultrasound. METHODS: The present study included 74 eyes of 59 patients undergoing cataract surgery. Operated eyes with mild cataract (nuclear sclerosis grade 1 and 2), moderate cataract (nuclear sclerosis grade 3) and hard cataract (nuclear sclerosis grade 4 and 5) were compared in terms of the total phacoemulsification (phaco) time, average phaco power, total phaco energy and amount of fluid used during cataract surgery between the 2 modalities. Endothelial cell density, corneal edema, central corneal thickness (CCT), surgically induced astigmatism (SIA) and best-corrected visual acuity (BCVA) were also evaluated preoperatively and up to 3 month postoperatively. RESULTS: In mild cataracts, the operative parameters and corneal changes were similar between the 2 modalities. In moderate cataracts, the total phaco time was significantly higher in the torsional group than the longitudinal group, but the average phaco power, total phaco energy, and amount of fluid were not significantly different. In patients with hard cataract, the torsional group showed higher total phaco time (27.50 +/- 17.77 sec vs. 97.08 +/- 12.67 sec), average phaco power, total phaco energy, persistent corneal edema at 1 week postoperatively and more endothelial cell loss at 3 month postoperatively (16.33 +/- 15.50% vs. 38.71 +/- 26.49%). Postoperative CCT, SIA and BCVA were not significantly different in hard cataracts between the 2 modalities. CONCLUSIONS: In mild and moderate cataracts, the efficiency of phaco and corneal changes were similar between the 2 modalities. However, recently improved longitudinal phaco showed superior efficiency for hard cataracts and induced less endothelial cell loss than torsional phaco.

Comparison of Clinical Features in Hypermetropic Children According to Refractive Error

PURPOSE: To investigate risk factors of esotropia, anisometropia and amblyopia and compare the clinical features in hypermetropic children according to the amount of hyperopia. METHODS: This study included 377 patients with cycloplegic refractive error of +1 D or greater at first visit. Patients were divided into 3 groups according to the refractive error. Odds ratios were calculated to evaluate the association of clinical risk factors with esotropia, anisometropi and amblyopia. Clinical features were compared between surgical and non-surgical groups. RESULTS: Hyperopia or =+6 D showed greater odds of bilateral amblyopia to 14.796 and hyperopia of or =3 D to or =2 D had a 5.386 times increased odds of esotropia and those younger than 2 years had a 5.578 times increased odds of esotropia. Surgical groups showed lower amount of hyperopia than non-surgical groups. Hyperopia or =2 D increased the risk for development of esotropia. Greater prevalence of bilateral amblyopia and lower prevalence of esotrpia was found predominantly in groups with higher amount of hyperopia. We recommend optical correction at an early age with higher hyperopia and surgical treatment should be considered for esotropic children with lower hyperopia.

Spontaneous Separation of Idiopathic Epiretinal Membrane in an Elderly Patient

PURPOSE: To report a case of spontaneous separation of idiopathic epiretinal membrane in an elderly patient. CASE SUMMARY: A 61-year-old male presented with decreased visual acuity in the right eye. He was diagnosed with idiopathic epiretinal membrane (ERM) in the right eye and posterior vitreous detachment (PVD) in both eyes. The patient underwent pars plana vitrectomy and ERM removal in the right eye. At postoperative 1 year, his vision in the right eye had improved, but idiopathic ERM developed in the left eye and visual acuity in the left eye decreased. Three years later, the ERM in the left eye resolved spontaneously and his vision increased. CONCLUSIONS: Herein we present a rare case of spontaneous separation of idiopathic ERM associated with a pre-existing PVD in an elderly patient and reviewed the available literatures regarding the possible mechanisms for the spontaneous separation of ERM in the presence of a pre-existing PVD.