The age range is wide, but a hard nucleus is being formed of former service personnel.
To evaluate the efficacy and safety of phacoemulsification using torsional modality with different parameter settings for hard nucleus cataract extraction.
Fifty-six patients of immature senile cataract with hard nucleus (grade 3 and 4) who underwent phacoemulsification were included.
In the case of a hard nucleus, it is easily occluded by the nucleus fragments and needs to be manually rinsed.
3 4 More ultrasonic energy and time are needed for hard nucleus removal than for softer ones, thus increasing the risk of surgical induced trauma, especially corneal endothelial dysfunction.
Torsional combined with ultrasound power or high fixed torsional amplitude can yield more effective hard nucleus phacoemulsification than conventional ultrasound modality.
5 Torsional works at a lower frequency of 32 kHz than the 40∼45 kHz in conventional phaco and theoretically reduces efficiency in lens removal, especially with hard nucleus.
It is reported in literature that endothelial cell loss rate after phacoemulsification with IOL implantation is greater in eyes with a hard nucleus than those with a soft nucleus [ 9- 11].
A randomized clinical trial was performed which comprised of 56 consecutive patients of immature senile cataract with hard nucleus, who attended ophthalmic out patient department at the Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
It is difficult to perform cataract surgery on an elderly patient owing to additional difficulties like coexisting systemic disorders, the difficulty of patient cooperation during surgery, higher incidence of hard nucleus, smaller pupil size and high rate of pseudoexfoliation syndrome.
The main aim of this randomised prospective clinical comparative study is to document the potential advantages of Torsional modality with or without ultrasound power setting over conventional Ultrasound modality alone for hard nucleus phacoemulsification.
