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Torsional and longitudinal phacoemulsification in type 2 diabetic patients: which one is better for the corneal endothelial cells?

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Session Details

Session Title: Evolution in FLACS & Phaco Technology

Session Date/Time: Sunday 23/09/2018 | 08:00-09:45

Paper Time: 08:51

Venue: Room A3, Podium 2

First Author: : D.Antono INDONESIA

Co Author(s): :    B. Budiman   A. Kartiwa                 

Abstract Details


It was estimated that 20% of cataract surgery were done in diabetic patients. There are increased vulnerability of corneal endothelial cells to damage induced by intraocular surgery in diabetic patients. Torsional ultrasound features oscillating rotary side movement, therefore improving the energy efficiency. The purpose of this study is to compare the postoperative corneal endothelial cell loss between torsional and longitudinal phacoemulsification mode in immature senile cataract with type 2 diabetes mellitus.


Cicendo National Eye Hospital Bandung, Indonesia


A double blind randomized controlled trial study was done in three months period. The subjects of this study were immature senile cataract patients with type 2 diabetes mellitus, aged 55-65 years old who came to cataract and refractive surgery clinic at Cicendo National Eye Hospital. Subjects were randomly assigned to torsional and longitudinal phacoemusification, which were done by one phaco surgeon. Ultrasound time (UST), and cumulative dissipated energy (CDE), were evaluated. Specular biomicroscopy were done preoperatively and on postoperative day seven. Statistical analysis used were independent T Test and Pearson correlation test.


The torsional group showed less endothelial cell loss (400,15±309,82 vs 880,16±406,25) at postoperative day seven. Pearson Correlation test revealed positive correlation between CDE and UST with endothelial cell loss (correlation coefficient of 0.59 and 0,58).


Torsional phacoemulsification gives less endothelial cell loss as compared to longitudinal phacoemulsification in immature cataract, therefore could possibly be the better choice for diabetic patients. However, further studies are still required.

Financial Disclosure:


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