Vitreous-lens interface changes after cataract surgery using active fluidics and active sentry with high and low infusion pressure settings

Abstract

Purpose: To determine if the infusion pressure used during phacoemulsification may have a detrimental effect on the Anterior Hyaloid Membrane Barrier (AHMB) in a pressure fluctuation-free environment via diagnostic SD-OCT post-operatively. Setting: Tandil Eye Clinic, Tandil, Buenos Aires, Argentina and Centro Oftalmológico Dr. Charles, CABA, Buenos Aires, Argentina. Design: Prospective randomized multicenter experimental and double-masked study. Methods: Phacoemulsification with intraocular lens implantation was done in all patients with the Centurion Vision System equipment with Active Fluidics and Active Sentry. Patients were randomly assigned to configuration 1 or 2. Configuration 1 intraocular pressure (IOP) 30 mmHg and configuration 2 intraocular pressure (IOP) 80 mmHg. Inclusion criteria: axial length > 22 mm < 25 mm, age > 50 < 70 years, complete adhesion of AHMB. Results: 80 eyes of 80 patients were included. Berger space was identified in 17 cases (42.5%) of group 2 and 3 cases (7.5%) of group 1 postoperatively via SD-OCT. A statistically significant relationship was established using Fisher's exact test (P = 0.0003). Postoperatively we observed PVD changes in only one patient (1.25%) during the three months of follow-up (p = 0.5). According to the Wong Baker faces scale, the patient's subjective perception was better for the low infusion pressure group (p = 0.0001 Fisher's exact test). Conclusions: Phacoemulsification with high infusion pressure can change the vitreous-lens interface. Positive Berger's space after phacoemulsification is a biomarker of this change and can occur in eyes without risk factors. Incidence is directly related to the infusion pressure used.