Active-fluidics-based torsional phacoemulsification in diabetic eyes: A prospective interventional study

Khokhar, Sudarshan; Sen, Sagnik; Dhull, Chirakshi

doi:10.4103/ijo.ijo_1146_18

Cited by 10 publications

(7 citation statements)

References 28 publications

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“…These results suggested that even in cases of comparable CDE and EFU, the application of the AFS could reduce cornea injuries, with shorter postoperative recovery time and better early postoperative BCVA. The phenomenon might be related to the stable fluidics of the AFS, which is able to reduce turbulent flushing of the perfusate from damaging the corneal endothelium [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

A prospective randomized clinical trial of active-fluidics versus gravity-fluidics system in phacoemulsification for age-related cataract (AGSPC)

Luo

Chen

et al. 2022

Annals of Medicine

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Background To figure out the efficacy, effects, safety and patient’s subjective perceptions of phacoemulsification with the active-fluidics system (AFS). Patients and methods This was a prospective, randomized, double-masked, controlled clinical study. Age-related cataract patients were recruited and randomly assigned to the AFS group and gravity-fluidics system (GFS) group in a ratio of 1:1 to have phacoemulsification. Participants were followed up at one day, one week, one month and three months postoperatively (Chinese Clinical Trial Registry, ChiCTR2100044409). Results The overall included participants were 107 finally. The total aspiration time of the AFS group was significantly less than that of the GFS group ( p = .020), while no significant difference existed in cumulative dissipated energy and estimated fluid usage between the two groups. The best corrected visual acuity was significantly better in the AFS group at one day and one week postoperatively ( p = .002, p = .038 respectively). The recovery of central corneal thickening and macular superficial vasculature increase was earlier in the AFS group. The central retinal thickness was significantly higher in the GFS group at one month and three months postoperatively ( p = .029, p = .016 respectively). The incidence of corneal adverse events was higher in GFS group ( p = .035). No serious adverse events occurred in either group. Pain scores and the scores of Cat-PROM5 questionnaire of the AFS group were significantly lower than that of the GFS group ( p = .011, p = .002 respectively). Conclusion AFS improves the efficiency, effects, safety and patients’ subjective perceptions of phacoemulsification compared with GFS. It is worthwhile to promote its application in cataract surgery. KEY MESSAGES The active-fluidics system automatically detects and maintains stable intraocular pressure at the set value. The active-fluidics system improves the efficiency, effects, safety and patients’ subjective perceptions in phacoemulsification.

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Section: Discussionmentioning

confidence: 99%

A prospective randomized clinical trial of active-fluidics versus gravity-fluidics system in phacoemulsification for age-related cataract (AGSPC)

Luo

Chen

et al. 2022

Annals of Medicine

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“…The global number of diabetic adults is expected to increase from 415 million to 642 million by 2040 [3][4][5]. Complications of diabetes are very different and impose serious damage to the heart, blood vessels, kidneys, nerves and eyes over time [6,7]. Ocular complications and changes in blood vessels cause damage to the retina in such way that the patient is not aware of the damage at an early stage [8].…”

Section: Introductionmentioning

confidence: 99%

The study of eye care behaviors in patients with type 2 diabetes

Lael-Monfared

Tehrani

Teiho

et al. 2020

J Diabetes Metab Disord

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Introduction The purpose of present study was to investigate eye care behaviors based on the BASNEF model and Health Locus of Control (HLOC) in patients with type 2 diabetes(T2D). Methods This cross-sectional analytical study was carried out on 150 patients with T2D in Iran in 2019. The subjects were selected using simple random sampling. The data collection tools included demographic, eye self-care behavior inventory based on BASNEF model and health locus of control whose validity and reliability were confirmed. Data analysis was carried out using Independent samples-t test ANOVA, and linear regression in SPSS ver. 24. Result The results of linear regression showed that knowledge, attitude, subjective norms, enabling factors, internal HLOC, chance HLOC and external HLOC were able to predict 17% of intention to eye self-care behaviors (P < 0.001) and attitude was the strongest construct in predicting intention of eye care behavior in patients with T2D (P < 0.05). In this study, most people had internal HLOC and mean (± SD) of their internal construct was 27.42(± 2.73). Also, the enabling factors construct showed a significant correlation with the internal HLOC (r = 0.283) and behavioral intention (r = 0.348) (P < 0.001). ConclusionThe results of this study showed that attitude and enabling factors are effective constructs in predicting the intention to perform preventive behaviors of ocular complications in T2D patients. Therefore, it is recommended to organize training classes, access resources, and educational information, facilitate access to physicians for eye examinations, create new skills for care and prevention of ocular complications.

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“…Despite the advances in cataract surgery technology, postoperative complications are inevitable, of which, corneal edema is the most frequent. Exposure to surgical lights, thermal injury from US energy, the collision of nuclear debris and the washout of irrigation fluid are all causes of corneal damage [ 39 ]. When the corneal endothelium is damaged, its unique “pump” function will become impaired, which would increase water content in the corneal stroma, lead to corneal edema and result in vision loss [ 40 ].…”

Section: Performance Of Afs In Pkementioning

confidence: 99%

“…Accompanying that loss is the inability of the cornea to maintain its dehydrated state, which can lead to corneal edema and endothelial decompensation. During PKE, the US energy is the most vital and direct contributor to CEC damages [ 39 ]. Therefore, better efficiency and less CDE are goals to be pursued relentlessly.…”

Section: Afs In Complicated Conditionsmentioning

confidence: 99%

“…Previous studies showed that cataracts combined with diabetes required more CDE and resulted in more corneal damages in PKE [ 60 , 61 ]. Meanwhile, a prospective clinical study reported similar surgical efficiency in patients with or without diabetes when PKE was performed with AFS [ 39 ]. Although the CCT was higher in the diabetic group 1 day postoperatively, the count of CECs 1 day and 1 month postoperatively did not differ significantly between the diabetics and nondiabetics.…”

Section: Afs In Complicated Conditionsmentioning

confidence: 99%

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Application of the Active-Fluidics System in Phacoemulsification: A Review

Luo

et al. 2023

JCM

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The fluidics system is an indispensable and primary component of phacoemulsification. Both the gravity-fluidics system and active-fluidics system are commonly used in practice. The irrigation pressure of the gravity-fluidics system is determined by the bottle height, which is relatively constant, while the active-fluidics system is paired with a cassette that contains pressure sensors to monitor intraocular pressure changes. The active-fluidics system allows surgeons to preset a target intraocular pressure value, and it replenishes the fluids proactively; thus, the intraocular pressure is consistently maintained near the target value. Under such circumstances, stable intraocular pressure and anterior chamber volume values could be acquired. Research on surgical safety, efficiency and results have reported several strengths of the active-fluidics system. It is also advantageous in some complicated cataract surgeries. However, the system is not widely used at present, mainly due to its low penetration rate and high equipment cost. Some of its updates such as the new Active Sentry handpiece showed potential superiority in laboratory studies recently, but there is still further research to be conducted. This article gives an overview of the mechanism and performance of the active-fluidics system, and it is expected to provide clues for future research.

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Active-fluidics-based torsional phacoemulsification in diabetic eyes: A prospective interventional study

Cited by 10 publications

References 28 publications

A prospective randomized clinical trial of active-fluidics versus gravity-fluidics system in phacoemulsification for age-related cataract (AGSPC)

A prospective randomized clinical trial of active-fluidics versus gravity-fluidics system in phacoemulsification for age-related cataract (AGSPC)

The study of eye care behaviors in patients with type 2 diabetes

Application of the Active-Fluidics System in Phacoemulsification: A Review

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