1. Outcomes of surgery for posterior polar cataract using torsional handpiece Dr. Aysel Pelit, Dr. Yonca A. Akova Baskent University, Faculty of Medicine, Adana, Turkey No author has a financial or proprietary interest in any material or method mentioned

2. Purpose The aims of this study were to report outcomes of surgery for posterior polar cataract using the OZil torsional handpiece. The aims of this study were to report outcomes of surgery for posterior polar cataract using the OZil torsional handpiece.

3. Method -I Medical records of 26 eyes of 21 consecutive patients with posterior polar cataract who had cataract surgery using the OZil torsional handpiece were evaluated Medical records of 26 eyes of 21 consecutive patients with posterior polar cataract who had cataract surgery using the OZil torsional handpiece were evaluated The cataract surgeries were performed by the same surgeon (AP) The cataract surgeries were performed by the same surgeon (AP) All surgeries were carried out under peribulbar anaesthesia All surgeries were carried out under peribulbar anaesthesia

4. Method-II Continuous curvilinear capsulorhexis was performed under an ophthalmic viscosurgical device Continuous curvilinear capsulorhexis was performed under an ophthalmic viscosurgical device Hydrodissection was avoided in order to prevent posterior capsule rupture Hydrodissection was avoided in order to prevent posterior capsule rupture All patients underwent hydrodelineation All patients underwent hydrodelineation For soft nucleus, the chip and flip technique was used. The parameter used were 100 mmHg and 20% torsional amplitude For soft nucleus, the chip and flip technique was used. The parameter used were 100 mmHg and 20% torsional amplitude

5. Method-III For harder nucleus (grade II-III), the stop and chop technique was used. The parameters used for trenching were 50-60 mm Hg vacuum and 80%-90% torsional amplitude. Emulsification was done at the 60%-70% torsional amplitude at an increased vacuum pressure of 100 mmHg. For harder nucleus (grade II-III), the stop and chop technique was used. The parameters used for trenching were 50-60 mm Hg vacuum and 80%-90% torsional amplitude. Emulsification was done at the 60%-70% torsional amplitude at an increased vacuum pressure of 100 mmHg. Throughout the procedure the aspiration flow rate was 16-18 ml/min at the bottle height of 50-60 cm Throughout the procedure the aspiration flow rate was 16-18 ml/min at the bottle height of 50-60 cm

6. Method-IV In all cases the epinucleus was aspirated and pulled towards the centre without crossing the central area In all cases the epinucleus was aspirated and pulled towards the centre without crossing the central area All cortex had been brought to the centre it was aspirated together with the central area All cortex had been brought to the centre it was aspirated together with the central area Usually, the plaque came out with the aspiration, but in some there was central posterior capsule rupture Usually, the plaque came out with the aspiration, but in some there was central posterior capsule rupture

7. Results Of the 26 eyes, 24 (92.3%) had small to medium posterior polar opacity. Two eyes had large opacity. Of the 26 eyes, 24 (92.3%) had small to medium posterior polar opacity. Two eyes had large opacity. Posterior capsule rupture occurred in 4 (15.3%) eyes. The mean visual acuity improved significantly after surgery (p<0.001). Posterior capsule rupture occurred in 4 (15.3%) eyes. The mean visual acuity improved significantly after surgery (p<0.001). The postoperative visual acuity was worse than 20/20 in 5 eyes. The cause of the low acuity was amblyopia. The postoperative visual acuity was worse than 20/20 in 5 eyes. The cause of the low acuity was amblyopia.

8. Conclusion Posterior polar cataract can be safely extracted using the OZil torsional handpiece. Posterior polar cataract can be safely extracted using the OZil torsional handpiece. Phacoemulsification using the OZil torsional handpiece leads to good visual outcome. Phacoemulsification using the OZil torsional handpiece leads to good visual outcome.