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Purpose <p>To compare the effects of the 45° Kelman phaco tip and the 45° Intrepid Balanced phaco tip used during torsional phacoemulsification in hard cataracts on intraoperative energy use and surgical times, as well as their effects on postoperative anterior segment parameters and the corneal endothelium.</p> Materials and Methods <p>In this retrospective comparative study, 180 eyes of 180 patients who met the inclusion criteria were included, comprising 90 patients in the 45° Intrepid Balanced phaco tip group and 90 patients in the 45° Kelman phaco tip group. Clinical findings were obtained preoperatively and on postoperative Day 1 and month 1, corneal endothelial and morphological parameters assessed by specular microscopy, optical biometry measurements were obtained, and intraoperative phacoemulsification device parameters were recorded. The groups were compared in terms of preoperative characteristics, intraoperative parameters, and postoperative corneal findings.</p> Results <p>There were no significant differences between the groups in terms of preoperative demographic or ocular characteristics. Compared with the Kelman group, the Intrepid Balanced group had significantly lower mean torsional amplitude, torsional ultrasound time, cumulative dissipated energy, aspiration time, and fluid usage (all <i>p</i> ≤ 0.007). However, there was no significant difference in total surgical time (<i>p</i> = 0.115). At postoperative month 1, the endothelial cell density was significantly greater in the Intrepid Balanced group than in the Kelman group (2075.52 ± 346.24 vs. 1929.96 ± 317.29 cells/mm<sup>2</sup>, <i>p</i> = 0.008). Endothelial cell loss (360.20 ± 207.25 vs. 500.22 ± 271.90 cells/mm<sup>2</sup>) and the percentage of endothelial cell loss (14.94 ± 8.64% vs. 20.37 ± 10.31%) were significantly lower in the Intrepid Balanced group (both <i>p</i> &lt; 0.001).</p> Conclusion <p>In torsional phacoemulsification for hard cataracts, the 45° Intrepid Balanced phaco tip was associated with greater intraoperative efficiency and less endothelial damage than the 45° Kelman phaco tip. These findings suggest that the Intrepid Balanced tip may offer advantages in terms of intraoperative efficiency and endothelial preservation under the surgical settings used in this study.</p>

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Comparison of 45° Kelman and 45° ıntrepid balanced phaco tips in torsional phacoemulsification for hard cataracts: ıntraoperative efficiency and corneal endothelial outcomes

  • 期刊论文

  • 发表日期：

    2026年5月16日

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  • Nurullah Berk Açar,
  • Okan Akmaz,
  • Tuncay Küsbeci,
  • Bora Yüksel,
  • Atılım Armağan Demirtaş,
  • Emre Ayıntap

摘要

Purpose

To compare the effects of the 45° Kelman phaco tip and the 45° Intrepid Balanced phaco tip used during torsional phacoemulsification in hard cataracts on intraoperative energy use and surgical times, as well as their effects on postoperative anterior segment parameters and the corneal endothelium.

Materials and Methods

In this retrospective comparative study, 180 eyes of 180 patients who met the inclusion criteria were included, comprising 90 patients in the 45° Intrepid Balanced phaco tip group and 90 patients in the 45° Kelman phaco tip group. Clinical findings were obtained preoperatively and on postoperative Day 1 and month 1, corneal endothelial and morphological parameters assessed by specular microscopy, optical biometry measurements were obtained, and intraoperative phacoemulsification device parameters were recorded. The groups were compared in terms of preoperative characteristics, intraoperative parameters, and postoperative corneal findings.

Results

There were no significant differences between the groups in terms of preoperative demographic or ocular characteristics. Compared with the Kelman group, the Intrepid Balanced group had significantly lower mean torsional amplitude, torsional ultrasound time, cumulative dissipated energy, aspiration time, and fluid usage (all p ≤ 0.007). However, there was no significant difference in total surgical time (p = 0.115). At postoperative month 1, the endothelial cell density was significantly greater in the Intrepid Balanced group than in the Kelman group (2075.52 ± 346.24 vs. 1929.96 ± 317.29 cells/mm2, p = 0.008). Endothelial cell loss (360.20 ± 207.25 vs. 500.22 ± 271.90 cells/mm2) and the percentage of endothelial cell loss (14.94 ± 8.64% vs. 20.37 ± 10.31%) were significantly lower in the Intrepid Balanced group (both p < 0.001).

Conclusion

In torsional phacoemulsification for hard cataracts, the 45° Intrepid Balanced phaco tip was associated with greater intraoperative efficiency and less endothelial damage than the 45° Kelman phaco tip. These findings suggest that the Intrepid Balanced tip may offer advantages in terms of intraoperative efficiency and endothelial preservation under the surgical settings used in this study.