| Objective:Cataract is the main eye disease which can cause to the blind around the world.The definite and effective treatment is extracting the turbid lens through surgery.At present,cataract surgery becomes perfect gradually,The significance of it is not simply to make patients see,it has changed into the refractive surgery. Phacoemulsification has become the first choice of most ophthalmologists for elective cataract surgery.More and more ophthalmologists realize that if the ultrasound time and energy is reduced as far as possible in the phacoemulsification, the surgical damages to intraocular tissues will be reduced to the utmost degree.In january 2006,Ozil tortional mode was incorporated into the Infiniti Vision System. Infiniti Vision System phacoemulsification machine has the function of the torsional mode-an emerging phacoemulsification technology.The level shearing that the phaco tip produced in the torsional mode can reduce the mount of phacoemulsification energy and increase the efficiency required to remove the cataractous nucleus.The purpose of the clinical observe is to evaluate the efficiency and safety of the tortional mode.Methods:The eyes that were dignosed as simple senile cataract were randomly assigned to phacoemulsification by conventional ultrasound(US) mode or torsional mode according to the registered order in the out-patient clinic.They were phacoemulsificated by conventional ultrasound(US) mode or torsional mode through a 2.2mm incision.All surgery was performed by the same surgeon and all used continuous mode of Infiniti Vision System.The MicroTip 0.9mm ABS (aspiration bypass system) phaco tip(30 degrees) was used with a standard setting in all patients.The same foldable Acrysof Nature IOL(Alcon laboratories) was inserted into the operated eye.The intraoperative data of ultrasound time(UST), ultrasound energy(CDE) and surgical complication were measured and compared, they are main parameter.Patients were seen at 1,7 days after surgery.Postopertive outcome measures the change of the uncorrected visual acuity(UCVA),the degree of corneal edema,and surgical complication.Results:The conventional ultrasound(US) group had 90 eyes and the torsional group,90eyes.The mean UST wasⅡ(20.2±5.5SD),Ⅲ(38.3±11.3SD),Ⅳ-Ⅴ(78.4±24.6SD),respectively,in the conventional US group andⅡ(16.6±4.7SD),Ⅲ(33.6±9.7SD),Ⅳ-Ⅴ(60.5±21.8SD),respectively,in the torsional group(p＜0.05); The mean CDE wasⅡ(4.82±1.4)%,Ⅲ(10.55±6.7)%,Ⅳ-Ⅴ(24.05±8.7) %,respectively,in the conventional US group andⅡ(3.45±1.2)%,Ⅲ(8.25±3.6) %,Ⅳ-Ⅴ(21.45±5.3)%,respectively,in the torsional group(p＜0.05).The mean UST and CDE were significantly lower in the torsional group than in the US group for each nucleus density grade.The differences in UST and CDE between subgroups of nucleus hardness were statistically significant.The UST and CDE consistently increased in eyes with higher grades of nucleus density(r=0.864).At 1 day after surgery,the proportion of severe corneal edema and Descemet' striae was higher in the conventional US group than in the torsional group.The difference betwween the 2 groups was statistically significant(p＜0.05).At 7 days after surgery,there was no corneal edema in either group,The difference betwween the 2 groups was no longer significant.At 1 day after surgery,the uncorrected visual acuity(UCVA) was significantly better in the torsional group than in the conventional US.The difference between the 2 groups was statistically significant(p＜0.05),but this advantage did not remain at 7 days after surgery.The difference between the 2 groups was not statistically significant(p＞0.05).Conclusion:The torsional mode with Infiniti Vision System phacoemulsification machine is an emerging phacoemulsification technology.It can reduce the ultrasound time(UST) and energy(CDE) and reduce the intraocular damage, particularly the corneal endothelial cell.Compared with the conventional US mode, the torsional mode is a safer and more effective phacoemulsification mode for cataract extraction.
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