.: ORİJİNAL ARAŞTIRMA
Comparison of Clear Corneal Incision Morphology Changes in Biaxial Microincision Cataract Surgery by Transverse and Torsional Phacoemulsification: Cohort Study
Transvers ve Torsiyonel Fakoemülsifikasyon ile Biaksiyel Mikroinsizyon Katarakt Cerrahisinde Saydam Korneal Kesi Değişikliklerinin Karşılaştırılması: Kohort Çalışması
Turkiye Klinikleri J Ophthalmol. 2022;31(4):239-47
doi: 10.5336/ophthal.2022-89711
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: To compare the effects of transverse versus torsional phacoemulsification by using the biaxial microincision cataract surgery technique on corneal structures and clear corneal incision (CCI) morphology. Material and Methods: We evaluated comparative case series of patients with moderate density nuclear cataracts who underwent biaxial microincision transverse or torsional phacoemulsification. Seventy patients have included in the study and they were divided into 2 groups: transverse and torsional. The main outcome measures included, corrected distance visual acuity, central corneal thickness, central corneal endothelial cell density, endothelial cell loss (ECL), and changes in the CCI morphology. Results: Each group comprised 35 (35 eyes) patients. Epithelial misalignment on the CCI morphology was highly significantly meaningful with the transverse group on the postoperative first day (p<0.001). Descemet membrane detachment on the first day postoperatively was high in both groups, especially in the transverse group, but the difference was not statistically significant (p=0.073). In the postoperative 3rd month, the mean ECL was 23.6% in the transverse group, and 19.0% in the torsional group, and there was no statistically significant difference between groups (p=0.187). Conclusion: In biaxial microincision cataract surgery, the corneal damage caused by transverse phacoemulsification seems to be higher compared to the torsional mode.
Keywords: Biaxial microincision; phacoemulsification; torsional; transverse
Objective: To compare the effects of transverse versus torsional phacoemulsification by using the biaxial microincision cataract surgery technique on corneal structures and clear corneal incision (CCI) morphology. Material and Methods: We evaluated comparative case series of patients with moderate density nuclear cataracts who underwent biaxial microincision transverse or torsional phacoemulsification. Seventy patients have included in the study and they were divided into 2 groups: transverse and torsional. The main outcome measures included, corrected distance visual acuity, central corneal thickness, central corneal endothelial cell density, endothelial cell loss (ECL), and changes in the CCI morphology. Results: Each group comprised 35 (35 eyes) patients. Epithelial misalignment on the CCI morphology was highly significantly meaningful with the transverse group on the postoperative first day (p<0.001). Descemet membrane detachment on the first day postoperatively was high in both groups, especially in the transverse group, but the difference was not statistically significant (p=0.073). In the postoperative 3rd month, the mean ECL was 23.6% in the transverse group, and 19.0% in the torsional group, and there was no statistically significant difference between groups (p=0.187). Conclusion: In biaxial microincision cataract surgery, the corneal damage caused by transverse phacoemulsification seems to be higher compared to the torsional mode.
Keywords: Biaxial microincision; phacoemulsification; torsional; transverse
ÖZET
Amaç: Transvers ve torsiyonel fakoemülsifikasyon ile biaksiyal mikroinsizyonel katarakt cerrahisinin kornea yapıları ve saydam kornea kesi morfolojisi üzerindeki etkilerini karşılaştırmaktır. Gereç ve Yöntemler: Biaksiyel mikroinsizyonel transvers veya torsiyonel fakoemülsifikasyon uygulanan orta yoğunluklu nükleer kataraktlı hastaların karşılaştırmalı vaka serilerini değerlendirdiğimiz bu çalışmada, 70 hasta çalışmaya dâhil edildi ve transvers ve torsiyonel olmak üzere 2 gruba ayrıldı. Her iki grupta düzeltilmiş görme keskinliği, merkezi kornea kalınlığı, merkezi kornea endotel hücre yoğunluğu, endotel hücre kaybı (EHK) ve saydam korneal kesi morfolojisindeki değişiklikler karşılaştırıldı. Bulgular: Her grup 35 (35 göz) hastadan oluşuyordu. Postoperatif 1. günde saydam korneal kesi morfolojisindeki epitel yanlış hizalanması transvers grupta istatistiksel olarak anlamlı derecede daha yüksekti (p<0,001). Ameliyat sonrası ilk gün Descemet membran dekolmanı her iki grupta da özellikle transvers grupta yüksekti, ancak aradaki fark istatistiksel olarak anlamlı değildi (p=0,073). Ameliyat sonrası 3. ayda ortalama EHK transvers grupta %23,6, torsiyonel grupta %19,0 idi ve gruplar arasında istatistiksel olarak anlamlı fark yoktu (p=0,187). Sonuç: Biaksiyel mikroinsizyonel katarakt cerrahisinde torsiyonel mod ile karşılaştırıldığında transvers mod fakoemülsifikasyonun yarattığı kornea hasarı daha fazla görünmektedir.
Anahtar Kelimeler: Biaksiyel mikroinsizyon; fakoemülsifikasyon; torsiyonel; transvers
Amaç: Transvers ve torsiyonel fakoemülsifikasyon ile biaksiyal mikroinsizyonel katarakt cerrahisinin kornea yapıları ve saydam kornea kesi morfolojisi üzerindeki etkilerini karşılaştırmaktır. Gereç ve Yöntemler: Biaksiyel mikroinsizyonel transvers veya torsiyonel fakoemülsifikasyon uygulanan orta yoğunluklu nükleer kataraktlı hastaların karşılaştırmalı vaka serilerini değerlendirdiğimiz bu çalışmada, 70 hasta çalışmaya dâhil edildi ve transvers ve torsiyonel olmak üzere 2 gruba ayrıldı. Her iki grupta düzeltilmiş görme keskinliği, merkezi kornea kalınlığı, merkezi kornea endotel hücre yoğunluğu, endotel hücre kaybı (EHK) ve saydam korneal kesi morfolojisindeki değişiklikler karşılaştırıldı. Bulgular: Her grup 35 (35 göz) hastadan oluşuyordu. Postoperatif 1. günde saydam korneal kesi morfolojisindeki epitel yanlış hizalanması transvers grupta istatistiksel olarak anlamlı derecede daha yüksekti (p<0,001). Ameliyat sonrası ilk gün Descemet membran dekolmanı her iki grupta da özellikle transvers grupta yüksekti, ancak aradaki fark istatistiksel olarak anlamlı değildi (p=0,073). Ameliyat sonrası 3. ayda ortalama EHK transvers grupta %23,6, torsiyonel grupta %19,0 idi ve gruplar arasında istatistiksel olarak anlamlı fark yoktu (p=0,187). Sonuç: Biaksiyel mikroinsizyonel katarakt cerrahisinde torsiyonel mod ile karşılaştırıldığında transvers mod fakoemülsifikasyonun yarattığı kornea hasarı daha fazla görünmektedir.
Anahtar Kelimeler: Biaksiyel mikroinsizyon; fakoemülsifikasyon; torsiyonel; transvers
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