The efficacy and safety profile of cataract procedures performed with a sensor-embedded handpiece and a new hybrid phaco tip

Abstract

Objective To evaluate the efficacy and safety of the new Intrepid Hybrid tip and Active Sentry handpiece in comparison to the Intrepid Balanced tip and Centurion Ozil handpiece. Methods One hundred sixty-eight eyes were included in the study and randomized into Group 1 (Active Sentry handpiece + Intrepid Hybrid tip, n = 86) and Group 2 (Centurion Ozil handpiece + Intrepid Balanced tip, n = 82). Data were collected from the phaco device, including total U/S time, cumulative dissipated energy (CDE), the total number of active surge mitigation actuations (ASM actuations), torsional amplitude, torsional amplitude on time, estimated fluid of aspirated, and aspiration time. Endothelial cell count (ECC) and central corneal thickness (CCT) were assessed. A correlation analysis was performed between ASM actuations, phaco metrics, and patient characteristics in Group 1. Results The CDE, torsional amplitude measured in Group 1 (8.8 ± 3.9, 51.2 ± 13.3, respectively) were significantly lower than those of Group 2 (10.4 ± 4.2, 65.2 ± 9.3, respectively). While no complications were observed in group 1, there were posterior capsule rupture in 2 eyes and iris damage in 1 eye in group 2. The mean ECC and CCT were similar at 1 month. The ASM actuations were more engaged in the eyes with pseudoexfoliation and small pupils. Conclusion The combination of the new Intrepid Hybrid tip and Active Sentry handpiece enables safer cataract procedures without compromising efficacy due to its surge prevention mechanisms and special tip design. It could be a good option for residents in training.

The comparison of handpiece anti-surge system and main body in cataract surgery

“…[13] Sabur H. et al reported that ASM actuations were more engaged in the eyes with pseudoexfoliation and small pupils. [25] In our results, Anti-surge (times), phacoemulsi cation time (seconds), CDE, and BSS use (ml) of the handpiece group were signi cantly increased in patients with zonule weakness and poor mydriasis compared with patients without, respectively (p < 0.05) (Table 3). And, anti-surge (times), phacoemulsi cation time (seconds), CDE, and BSS use (ml) were signi cantly increased according to increasing nucleosclerosis grades in the handpiece group, respectively (p < 0.05) (Table 2).…”

Comparison of INTREPID® balanced and hybrid tips on anterior capsule rupture in ex vivo porcine eyes

“…Also, besides removing opacified lenses one can significantly reduce the risk of postoperative corneal astigmatism with smaller incision sizes and sophisticated intraocular lenses, resulting in good postoperative visual acuity through refractive correction [ 24 ]. More efficient energy transmission to the phaco tip was reported for Group-M than Kelman tips [ 25 ]; and safer crushing and aspiration of lens cortex and nucleus due to the polymer overmold of a Group-P tip avoided damage to the iris and lens capsule [ 24 ]. There have been few reports of the polymer overmold tip; one compared efficacy and safety among the Active Sentry handpiece with Group-P and the Centurion OZil handpiece with Group-M in clinical surgical data, and reported the former showed significantly lower cumulative dissipated energy and torsional amplitude with no cataract surgery complications observed [ 24 ].…”

“…It has been reported that recent cataract surgery requires less energy to emulsify opacified lenses as previously, since the number of cases presenting with high grades and hard nuclei has decreased [15][16][17][18][19][20][21][22][23]. Also, besides removing opacified lenses one can significantly reduce the risk of postoperative corneal astigmatism with smaller incision sizes and sophisticated intraocular lenses, resulting in good postoperative visual acuity through refractive correction [24]. More efficient energy transmission to the phaco tip was reported for Group-M than Kelman tips [25]; and safer crushing and aspiration of lens cortex and nucleus due to the polymer overmold of a Group-P tip avoided damage to the iris and lens capsule [24].…”

Comparison of patient experiences and clinical outcomes between an illuminated chopper and a conventional chopper under a surgical microscope

“…This study compared U/S time between the iChopper and control groups in each institution because U/S time was recorded differently by each phacoemulsification machine (effective phacoemulsification time [EPT], total U/S time, and EFX [U/S % and time used during phacoemulsification]). 20,21 This study conducted a chi-square test to compare laterality. A repeated-measures analysis of variance (ANOVA) was conducted to compare UDVA, CDVA, corneal ECD, hexagonality, CoV, central macular thickness, CCC size, and ACO and PCO scores during the follow-up periods between the 2 groups.…”