Surgical parameter assessment using two Phacoemulsification Systems for grade I to IV cataracts

Abstract

Aim: To compare the cumulative dissipated energy (CDE), aspiration fluid and aspiration time used during phacoemulsification using two surgical platforms. Methods: Consecutive eyes from patients undergoing cataract surgery were included. Lens opacities were graded from NO1NC1 to NO6NC6 using the LOCS III classification. Two platforms were evaluated: 1.Centurion® system with active-fluidics. 2. Infiniti ® Vision System with gravity-fluidics. Cumulative dissipated energy (CDE), aspiration time (AT) and mean estimated aspiration fluid (EAF) were registered and compared. Results: A total of 216 eyes were evaluated. Mean age ± SD was 78.3 ± 9.8 years (range 57 to 92). Significant differences were evidenced for overall CDE per nuclear density for cataracts grade II to IV (p = 0.031, p =0.045 and p = 0.032 respectively). Aspiration time showed a significant disparity for cataracts graded II and III (p = 0.024 and p = 0.001), as the Estimated Aspiration Fluid (p = 0.001 and p = 0.042 respectively). All differences favoured the active-fluidics configuration group. Conclusions: Active-Fluidics System demonstrated to be more effective than Gravity-fluidics system for cataracts grade II-IV phacoemulsification.

Active-fluidics versus gravity-fluidics in lens extraction: A systematic review and meta-analysis of randomized controlled trials

“…Out of 7606 articles, 6 RCTs 11–15,24 involving 884 patients were included in the study and were qualitatively synthesized (Supplementary Figure 1). One study 13 had three arms.…”

“…For quantitative analysis, one study was excluded 24 because it had insufficient data for statistical analysis. We contacted the authors but received no reply.…”

“…The number of eyes per study ranged from 72 to 216, and the mean age ranged from 61.15 to 73 years. Two, two, and one studies graded cataracts according to the lens opacities classification system (LOCS) II, 11,15 LOCS III, 13,24 and Emery–Little classification system, 14 respectively; one study did not report the grading system used. 12 Two studies used only the Centurion system (Alcon, Fort Worth, Texas, US) and balanced tips (Alcon, Fort Worth, Texas, US), 12,14 whereas the other studies used both the Centurion and Infinity systems (Alcon, Fort Worth, Texas, US) with balanced and Kelman tips (Alcon, Fort Worth, Texas, US).…”

“…The selection bias and performance bias for most of the studies 11,12,14,15,24 could not be evaluated because they did not report their methods for random sequence generation, whether the allocation was concealed, and whether the participants and personnel were blinded (Supplementary Figure 2). One study 24 was determined to carry a high risk of reporting bias because the number of patients in each group was not reported.…”

“…First, all the included studies had some bias stemming from random sequence generation, allocation concealment, and the blinding of participants and medical personnel. Because some of the studies compared older and newer systems, 11,13,15,24 the surgeons’ confidence when performing surgeries may have been affected, either due to them being unfamiliar with the new system or being aware of that they were using an older system. Second, one article 24 did not include the numbers of patients in the study groups, and the authors did not reply to our request for the missing data.…”