To compare clinical outcomes of a 2.2 mm microcoaxial cataract surgery, using torsional mode and longitudinal mode.

In this comparative study, patients with bilateral cataract were assigned to get microcoaxial cataract surgery by torsional mode of infiniti in one eye and longitudinal mode of Stellaris® in the other eye. Primary outcome measures were US time (UST), cumulative dissipated energy (CDE), mean amount of balanced salt solution (BSS) used and surgical complications. Patients were seen 1, 7, 30, and 60 days after surgery. Postoperative outcome measures were the final best corrected visual acuity (BCVA), central corneal thickness (CCT), endothelial cell count and surgically induced astigmatism (SIA).

The study evaluated 68 eyes of 34 patients (nuclear opalescence (NO)2: 40 eyes, and NO3: 28 eyes). CDE was significantly lower in torsional mode (3.52 ± 2.93) than in longitudinal mode (6.20 ± 3.32) ( p = 0.001). Torsional mode (60.88 ± 21.18 ml) had more BSS use than longitudinal mode (34.58 ± 13.54 ml) ( p < 0.001). There were no significant differences in postoperative BCVA, CCT change, endothelial change, and SIA ( p > 0.05).

The torsional mode may provide lower level of phacoemulsification energy than the longitudinal mode and Torsional mode is considered effective and safe phacoemulsification. However the surgical outcomes were not significantly different in 2.2 mm microcoaxial cataract surgery of moderate cataract. So surgeon can choose any phaco machine based on experience and preference.