Comparison of Phacoemulsification Cataract Surgery with Low versus Standard Fluidic Settings and the Impact on Postoperative Parameters

Chang, Anthony; Fridberg, Alexander; Kugelberg, Maria

doi:10.5301/ejo.5000813

Cited by 7 publications

(15 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Keeping aside machine and tip factors, several other factors can lead to ECL during PKE, as observed by different authors, such as incision size and design, increasing hardness of nucleus, different PKE techniques, differing composition of irrigating fluids or OVD /drugs, instrumental injury, surgeons’ experience, older age, type, and delivery technique of IOL, formation of free radicals, smaller pupil size. [ 18 19 20 ] In our study, other than modes, we tried our best to avoid the bias arising from all these factors as described in methodology.…”

Section: Discussionmentioning

confidence: 99%

Comparative studies between longitudinal and torsional modes in phacoemulsification, using active fluidics technology along with the intrepid balanced tip

Dasgupta¹,

Mehra²

2018

Indian J Ophthalmol

View full text Add to dashboard Cite

Purpose:To compare and report the intra- and postoperative outcomes of phacoemulsification between longitudinal (LPKE) and torsional (TPKE) mode, using active fluidics along with the intrepid balanced tip.Methods:This single center prospective randomized comparative study comprised a total 108 consecutive eyes of 108 patients having senile cataract subdivided into nuclear opalescence (NO) grades II–IV according to the lens opacities classification system III (LOCS III). Cataracts of each grade were randomly assigned to two groups LPKE (n = 54) and TPKE (n = 54) mode, who were operated on by the same surgeon using same machine (Centurion® Alcon Laboratories, Inc., USA) having features of both active fluidics and intrepid balanced tip. Pre-, intra-, and postoperative evaluations were done independently by a different author, who was masked to the surgical procedures. Patients were evaluated on the postoperative days (PODs) 1, 7, 15, and 28. Intraoperative outcome measures were cumulative dissipated energy (CDE) and ultrasound time (UST). Postoperative outcome measures were endothelial cell loss (ECL), central corneal thickness (CCT), and best-corrected visual acuity (BCVA).Results:Age, gender, and NO-grade distribution among two modes were comparable (P > 0.05). Difference of CDE and UST between modes were found to be significant (P < 0.001) in favor of TPKE with all NO-grades. TPKE mode performs better than LPKE mode with regard to ECL, CCT-change, and BCVA-change, although the differences were found to be insignificant (P > 0.05).Conclusion:When using active fluidics along with the intrepid balanced tip, TPKE mode appeared to be a more efficient mode of PKE with reduced mean UST and CDE across all NO-grades, as compared to LPKE mode. However, ECL, CCT-change, and BCVA-change were seemed to be comparable between the two modes.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparative studies between longitudinal and torsional modes in phacoemulsification, using active fluidics technology along with the intrepid balanced tip

Dasgupta¹,

Mehra²

2018

Indian J Ophthalmol

View full text Add to dashboard Cite

show abstract

“…The study selection flowchart is presented in Supplementary Figure S1. We initially identified a total of 1,111 records through the systematic search, and after screening the study titles and abstracts, 12 potential articles (4,(9)(10)(11)(12)(13)(20)(21)(22)(23)(24)(25) were evaluated for final eligibility. Of these potential records, we excluded two studies which were not designed as randomized controlled trials (23,24), one study lacking comparisons between high-flow and low-flow phacoemulsification cataract surgery (25), and three studies without final reports (20)(21)(22).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…In addition, phacoemulsification may also trigger inflammation, thus leading to macular edema. However, several randomized controlled trials (RCTs) with small sample sizes reported inconsistent surgical outcomes, regarding ECL, central corneal thickness (CCT) and central macular thickness (CMT), after high-or low-flow phacoemulsification cataract surgery (4,(9)(10)(11)(12)(13). To summarize the current evidence and better inform clinical decision-making, we conducted a systematic review and meta-analysis study on the surgical outcomes reported from RCTs comparing high-flow and low-flow phacoemulsification cataract surgery.…”

Section: Introductionmentioning

confidence: 99%

Comparative anatomical outcomes of high-flow vs. low-flow phacoemulsification cataract surgery: A systematic review and meta-analysis

Kuo

Hung²,

Su³

et al. 2022

Front. Med.

View full text Add to dashboard Cite

BackgroundPhacoemulsification is an effective and widely performed technique in cataract surgery, but the comparative anatomical outcomes, including endothelial cell loss (ECL), central corneal thickness (CCT), and central macular thickness (CMT), between high-flow and low-flow phacoemulsification cataract surgery remain unclear.MethodsThis study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Random-effects models were applied to measure pooled mean differences (MD) with 95% confidence intervals (CI) of anatomical outcomes between high-flow and low-flow phacoemulsification cataract surgery. We judged overall certainty of evidence (CoE) based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.ResultsWe included six randomized controlled trials (RCTs) totaling 477 participants. The meta-analysis showed similar changes associated with these two surgery types in both ECL at postoperative days 2–14 (MD: −1.63%; 95% CI: −3.73 to 0.47%; CoE: very low), days 15–42 (MD: −0.65%; 95% CI −2.96 to 1.65%; CoE: very low) and day 43 to month 18 (MD: −0.35%; 95% CI: −1.48 to 0.78%; CoE: very low), and CCT at postoperative day 1 (MD: −16.37 μm; 95% CI: −56.91 to 24.17 μm; CoE: very low), days 2–14 (MD: −10.92 μm; 95% CI: −30.00 to 8.16 μm; CoE: very low) and days 15–42 (MD: −2.76 μm; 95% CI: −5.75 to 0.24 μm; CoE: low). By contrast, low-flow phacoemulsification showed less increase in CMT at postoperative days 15–42 (MD, −4.58 μm; 95% CI: −6.3 to −2.86 μm; CoE: low).ConclusionsWe found similar anatomical outcomes, except in CMT, for both high-flow and low-flow phacoemulsification cataract surgery. Future head-to-head RCTs on visual outcomes should confirm our findings.Systematic review registrationPROSPERO, identifier: CRD42022297036.

show abstract

“…A certain amount of fluid passes through the zonules from the anterior chamber to the vitreous cavity, inducing anatomical and biochemical changes, increasing the risk of PVD . In particular, the phacoemulsification technique and the level of experience of the surgeon can additionally increase the amount of intraoperative manipulation and prolong surgery time . Longer surgery and operative settings with more fluid movement and turbulence imply that an additional amount of vibrations might be transferred to the anterior hyaloid, which induces PVD …”

mentioning

confidence: 99%

Re: Evaluation of posterior vitreous detachment after uneventful phacoemulsification surgery by optical coherence tomography and ultrasonography

Zvorničanin

2017

Clinical and Experimental Optometry

View full text Add to dashboard Cite

Comparison of Phacoemulsification Cataract Surgery with Low versus Standard Fluidic Settings and the Impact on Postoperative Parameters

Abstract: Although the surgical time and ECD were significantly higher in the group with low fluidic settings, there were no differences in the CCT, ECD, macular thickness, or inflammation postoperatively between the low and standard fluidic settings during phacoemulsification.

Cited by 7 publications

References 15 publications

Comparative studies between longitudinal and torsional modes in phacoemulsification, using active fluidics technology along with the intrepid balanced tip

Comparative studies between longitudinal and torsional modes in phacoemulsification, using active fluidics technology along with the intrepid balanced tip

Comparative anatomical outcomes of high-flow vs. low-flow phacoemulsification cataract surgery: A systematic review and meta-analysis

Re: Evaluation of posterior vitreous detachment after uneventful phacoemulsification surgery by optical coherence tomography and ultrasonography

Contact Info

Product

Resources

About