Comparison Of Bimanual And Micro-Coaxial Phacoemulsification With Torsional Ultrasound

Purpose: To evaluate the efficacy and postoperative outcomes of bimanual and micro-coaxial phacoemulsification with torsional ultrasound.Methods: In this prospective randomized series, eyes with age-related cataract were randomly divided into bimanual phacoemulsification and micro-coaxial phacoemulsification groups. Data included preoperative and postoperative corrected distance visual acuity (CDVA), central / temporal corneal thickness, endothelial cell density and intraoperative ultrasound time, cumulative dissipated energy and balanced salt solution volume.Results: The study evaluated 89 patients (89 eyes). When compared between micro- coaxial and bimanual phaco groups, ultrasound time (57 +/- 24 second versus 85 +/- 40 second, p < 0.01), cumulative dissipated energy (10 +/- 7 versus 14 +/- 7, p = 0.01) and balanced salt solution volume (55 +/- 19 ml l versus 75 +/- 20 ml, p < 0.01) were significantly lower in micro-coaxial phaco group. At 1 day, there were no statistically significant differences in CDVA (p = 0.68) or central corneal thickness (p = 0.48) between two groups; temporal corneal thickness was statistically significantly thicker in bimanual phaco group (1247 +/- 123 mu m) than that in micro- coaxial phaco group (1108 +/- 131 mu m, p = 0.01). There were no statistically significant differences in CDVA, central / temporal corneal thickness, or endothelial cell density between two groups 30 days postoperatively (all p values > 0.05).Conclusion: With rapid visual rehabilitation and comparable endothelial cell loss, both bimanual and micro- coaxial phacoemulsification procedures with torsional ultrasound are efficient for moderate nuclear cataract extraction.