Comparison of 45-degree Kelman and 45-degree balanced phaco tip designs in torsional microcoaxial phacoemulsification

AIM: To compare the intraoperative performance and postoperative outcome after microcoaxial torsional phacoemulsification using either a Kelman or balanced phaco tip. METHODS: Cataracts were treated using 2.2 mm microcoaxial torsional phacoemulsification using either a 45-degree mini-flared Kelman® or a 45-degree Intrepid® Balanced phaco tip. Intraoperative measurements included total ultrasound (US) time, cumulative dissipated energy (CDE), torsional US time, and balanced salt solution (BSS) use. The central endothelial cell density (ECD) and central corneal thickness (CCT) were evaluated preoperatively and postoperatively 1, 7, and 30d after surgery using noncontact specular microscopy. RESULTS: The 116 enrolled eyes (116 patients) were divided equally between the Kelman and balanced tip groups. Intraoperative measurements showed significantly less total US time, torsional US time, CDE, and BSS use in the balanced group than in Kelman group (P<0.05). The total US time, torsional US time, CDE, and BSS use were 17.45±14.53s, 16.63±13.97s, 6.38±5.26, and 48.21±17.21 mL in the Kelman group and 11.39 ± 9.60s, 10.90 ± 9.25s, 4.04 ± 3.42, and 41.36 ± 12.70 mL in the balanced group, respectively. CONCLUSION: Torsional phacoemulsification performed with a balanced tip provided more effective lens removal with less total US time, torsional time, CDE, and BSS use, as well as similar changes in ECD with a Kelman tip in all cataract grades. This special designed phaco tip for torsional phacoemulsification provides an alternative phaco tip for many surgeons' preference with straight phaco tip

Comparison of 21G curved and straight phacotips designs in transversal microcoaxial phacoemulsification

AIM:To compare the intraoperative performance and postoperative outcomes after microcoaxial torsional phacoemulsification using the straight and the curved phacotip configurations.METHODS:Cataracts were treated using 2.2mm microcoaxial transversal phacoemulsification with either a 30°straight or 30° curved phaco tip. Intraoperative measurements analyzed included the average ultrasound(U/S)power, the total phacoemulsification time, and the effective phacoemulsification time(EPT). The central endothelial cell density(ECD)and the central corneal thickness(CCT)were evaluated preoperatively and postoperatively at 1, 7 and 30d after surgery using noncontact specular microscopy. RESULTS:The study enrolled a total of 190 eyes(190 patients), 95 eyes in the curved tip group and 95 eyes in straight tip group. Intraoperative measurements showed significantly reduced total phacoemulsification time, and EPT in the curved-tip group, compared to the straight-tip group(Pst-3rd quartiles)and 18.0(9.0-30.0)s in curved-tip group, and 38.8(16.5-73.5)s and 26.0(11.0-49.0)s in the straight-tip group, respectively. CONCLUSION:Transversal phacoemulsification performed with a curved tip provided more effective lens removal with a less total UST and EPT in all grades, except for grades IV, compared to a straight tip

The effect of single dose of brimonidine-purite 0.15 on choroidal thickness in healthy volunteers

AIM: To evaluate the potential posterior segment effects of topical application of brimonidine-purite 0.15% through measurement of choroidal thickness(CT)in healthy eyes using enhanced depth imaging spectral-domain optical coherence tomography(EDI-SD-OCT).METHODS: Thirty-two eyes of 32 healthy subjects were included in this prospective, placebo-controlled interventional clinical trial. They received one drop of topical preservative-free artificial tears as placebo for the first day and one drop of brimonidine-purite 0.15% for the second day. Intraocular pressure, ocular perfusion pressure(OPP), and EDI-SD-OCT were performed at baseline, at 1, 3 and 5h after the treatments.RESULTS: Compared to the measurements obtained at baseline, the CT measurements obtained after the topical application of brimonidine-purite 0.15% significantly increased at the sub-fovea(P=0.001), at temporal 1500 μm to the fovea(P=0.003)and at nasal 1500 μm to the fovea(P=0.003). Choroidal thickness was unchanged in placebo group during the study(P >0.05). There was no significant reduction in the OPP in both groups(P >0.05). There were no adverse events during the study.CONCLUSIONS: Contrary to expectations, topical administration of brimonidine-purite 0.15% resulted with thickening of sub-foveal, temporal and nasal CT. This might be related to altered auto-regulation mechanisms in choroidal vessels