Comparison of Endothelial Cell Changes between Torsional and Conventional mode Phacoemulsification

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Pornchai Simaroj Nattaya Sinprasertkool Walee Chochaichamnankit Nutsuchar Wangtiraumnuay Kaevalin Lekhanont


Objective:To compare corneal endothelial cell loss in cataract surgery performed with conventional phacoemulsification and torsional phacoemulsification at Ramathibodi hospital.

Methods: Prospective randomized double-blind controlled trial study at Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University. Fifty eyes of 50 patients with grade 2 to 4 senile cataract (according to the Oxford classification) were randomized to have either conventional mode or torsional (OZil) mode phacoemulsification using the Infiniti Vision System. All surgeries were performed by a single experienced surgeon. A complete ophthalmologic examination was performed preoperatively and postoperatively at 1 and 7 days, and 1, 3, 6, and 12 months. Central corneal thickness (CCT) and endothelium cell parameters were measured preoperatively and postoperatively at 3, 6 and 12 months. Primary outcomes were best-corrected visual acuity (BCVA), endothelial cell density (ECD) and CCT.

Results: Preoperatively, there was no significant difference in cataract grading between 2 groups. The mean preoperative ECD was 2,521.62 ± 331.32 (1,784-3,206) cell/mm2 in the conventional group (28 patients) and 2,631.52 ± 290.75 (1,742-3,127) cell/mm2 in the torsional group (22 patients). The mean postoperative ECD at 12 months was 2,315.21 ± 385.45 (1,245-3,183) and 2,261.82 ± 292.64 (1,672-2,872) cell/mm2 in the conventional and torsional groups respectively. The mean endothelial cell loss was 9.70% in the conventional group and 12.68% in the torsional group, with no statistically significant difference between the two groups (P = 0.54). No significant differences in postoperative BCVA and CCT were found between the 2 groups.

Conclusions: Torsional mode phacoemulsification appears to be safe for corneal endothelial cells as well as conventional mode. 


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How to Cite
Simaroj, P., Sinprasertkool, N., Chochaichamnankit, W., Wangtiraumnuay, N., & Lekhanont, K. (1). Comparison of Endothelial Cell Changes between Torsional and Conventional mode Phacoemulsification. Ramathibodi Medical Journal, 39(2), 110-116. Retrieved from
Original Articles


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