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Evaluation of intraoperative and postoperative outcomes of torsional mode versus longitudinal ultrasound mode phacemulsification: a meta-analysis

Poster Details

First Author: PiaLeon ITALY

Co Author(s):    Ingrid Umari   Alessandro Mangogna   Andrea Zanei   Paolo Cecchini   Daniele Tognetto  

Abstract Details


To evaluate and to compare the intraoperative parameters and postoperative outcomes of Torsional mode and Longitudinal mode of phacoemulsification.


: University Eye Clinic of Trieste (Italy) Ospedale Maggiore. Piazza Ospedale, 1 34129 Trieste (Italy)


Pertinent studies were identified by a computerized MEDLINE search from 2002 to September 2013 using the following search items: ""Torsional Phacoemulsification”, ""Longitudinal Phacoemulsification”, ""Longitudinal Torsional Phacoemulsification”; and ""Torsional Conventional Phacoemulsification”. Only studies published in English were considered. 117 potential relevant articles were evaluated, 7 studied were included in the meta-analysis. The meta-analysis is composed of two parts. In the first part the intraoperative parameters were considered: Ultrasound Time (UST) and Cumulative Dissipated Energy (CDE). In the second part of the study the postoperative outcomes were taken in consideration: the Best-Correct Visual Acuity (BCVA) after a day and a month and the Endothelial Cell Loss (ECL) after a week, a month and three months of follow-up. Statistical analysis was performed using CMA ver. 2.2 (Biostat®, Englewood, NJ USA).


5 studies for a total of 1119 eyes were included in the evaluation of intraoperative parameters. The UST and CDE values proved statistically significant in support of the Torsional mode in the all surgeries considered with a standardized mean difference (Std diff in means) of -0.708 (95% CI, -0.833 to -0.584, p = 0.00) for UST and -0.533 (95% CI, -0.656 to -0.409, p = 0.00) for CDE. 3 studies for a total of 1125 eyes were considered in the evaluation of BCVA at 1 day (p = 0.87) and 1 month (p = 0.69). 5 studies for a total of 1279 eyes were used for the evaluation ECL: 3 for analysis at 1 week, 2 for analysis at 1 month and 3 months. In both analysis Torsional mode demonstrated statistical superior postoperative endothelial cell count than Longitudianl phacoemulsification (p <0.001).


The meta-analysis shows the superiority of the Torsional mode for intraoperative parameters (UST, CDE) and postoperative outcomes (ECL). FINANCIAL INTEREST: NONE

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