J Korean Ophthalmol Soc.  2017 Jan;58(1):27-33. 10.3341/jkos.2017.58.1.27.

Comparison between Active and Gravity-based Phacoemulsification Fluidics Systems in Immediate Sequential Bilateral Cataract Surgery

• Kong SJ
• Jang C
• Lim TH
• Choi KY
• Cho BJ

• KMID: 2367838
• DOI: http://doi.org/10.3341/jkos.2017.58.1.27

Abstract

PURPOSE
To compare the clinical outcomes during phacoemulsification when using active fluidics (Centurion®) and gravity-based fluidics (Infiniti®) in immediate sequential bilateral cataract surgery.
METHODS
From January 2015 to September 2015, 68 eyes of 34 patients with bilateral cataract were assigned to receive immediate sequential bilateral cataract surgery by Centurion® in one eye and Infiniti® in the other eye. We measured and compared intraoperative factors, including cumulative dissipated energy (CDE), ultrasound time, mean amount of balanced salt solution (BSS) used, and pain using a scale. Best corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell density (ECD) were also evaluated preoperatively and 1 month postoperatively.
RESULTS
Intraoperative measurements showed significantly less CDE (5.05 ± 2.18 vs. 7.05 ± 3.82), ultrasound time (24.65 ± 9.68 vs. 34.95 ± 17.95 seconds), and mean amount of BSS used (37.06 ± 10.25 vs. 44.88 ± 16.38 mL) in the Centurion® group than in the Infiniti® group (p = 0.011, p = 0.005, p = 0.021, respectively). The intraoperative pain scale was 0.26 ± 0.51 in the Centurion® group and 0.50 ± 0.71 in the Infiniti® group, and was not significantly different (p = 0.121). BCVA, increase of CCT and decrease of ECD were not significantly different between the two groups at 1 month postoperatively.
CONCLUSIONS
The efficacy of phacoemulsification in the Centurion® group was superior to that in the Infiniti® group. The level of intraoperative pain and clinical outcomes 1 month after surgery were not significantly different between the two groups.

Keyword

Active fluidics; Cumulative dissipated energy; Gravity-based fluidics; Immediate sequential bilateral cataract surgery; Pain

MeSH Terms

Cataract*
Endothelial Cells
Humans
Phacoemulsification*
Ultrasonography
Visual Acuity

Reference

References

1. Kelman CD. Phaco-emulsification and aspiration. A new techni-que of cataract removal. A preliminary report. Am J Ophthalmol. 1961; 66:111–24.

2. Liu Y, Zeng M, Liu X, et al. Torsional mode versus conventional ultrasound mode phacoemulsification: randomized comparative clinical study. J Cataract Refract Surg. 1961; 66:111–24.

3. Christakis PG, Braga-Mele RM. Intraoperative performance and postoperative outcome comparison of longitudinal, torsional, and transversal phacoemulsification machines. J Cataract Refract Surg. 1961; 66:111–24.

4. Ataş M, Demircan S, Karatepe Haş haş AS, et al. Comparison of corneal endothelial changes following phacoemulsification with transversal and torsional phacoemulsification machines. Int J Ophthalmol. 1961; 66:111–24.

5. Zeng M, Liu X, Liu Y, et al. Torsional ultrasound modality for hard nucleus phacoemulsification cataract extraction. Br J Ophthalmol. 1961; 66:111–24.

6. Seibel BS. Phacodynamics: mastering the tools and techniques of phacoemulsification surgery. 4th ed.Thoroughfare: Slack;2005. p. 122–3.

7. Zhao Y, Li X, Tao A, et al. Intraocular pressure and calculated diastolic ocular perfusion pressure during three simulated steps of phacoemulsi-fication in vivo. Invest Ophthalmol Vis Sci. 1961; 66:111–24.

8. Seibel B. Phacodynamic links to complications. Fishkind WJ, editor. Complications in Phacoemulsification. Avoidance, Recognition, and Management. 1st ed.New York: Thieme;2002. p. chap. 25.

9. Findl O, Strenn K, Wolzt M, et al. Effects of changes in intra-ocular pressure on human ocular haemodynamics. Curr Eye Res. 1961; 66:111–24.

10. Nicoli CM, Dimalanta R, Miller KM. Experimental anterior cham-ber maintenance in active versus passive phacoemulsification flu-idics systems. J Cataract Refract Surg. 1961; 66:111–24.

11. Yaylali V, Yildirim C, Tatlipinar S, et al. Subjective visual experi-ence and pain level during phacoemulsification and intraocular lens implantation under topical anesthesia. Ophthalmologica. 1961; 66:111–24.

12. Apil A, Kartal B, Ekinci M, et al. Topical anesthesia for cataract sur-gery: the patients' perspective. Pain Res Treat. 2014; 2014:827659.

13. Walkow T, Anders N, Klebe S. Endothelial cell loss after phacoe-mulsification: relation to preoperative and intraoperative para-meters. J Cataract Refract Surg. 1961; 66:111–24.

14. Holladay JT, Cravy TV, Koch DD. Calculating the surgically in-duced refractive change following ocular surgery. J Cataract Refract Surg. 1961; 66:111–24.

15. Hayashi K, Hayashi H, Nakao F, Hayashi F. Risk factors for cor-neal endothelial injury during phacoemulsification. J Cataract Refract Surg. 1961; 66:111–24.

16. Rekas M, Montés-Micó R, Krix-Jachym K, et al. Comparison of torsional and longitudinal modes using phacoemulsification parameters. J Cataract Refract Surg. 1961; 66:111–24.

17. Vasavada AR, Praveen MR, Vasavada VA, et al. Impact of high and low aspiration parameters on postoperative outcomes of phacoe-mulsification: randomized clinical trial. J Cataract Refract Surg. 1961; 66:111–24.

18. Chen M, Anderson E, Hill G, et al. Comparison of cumulative dis-sipated energy between the Infiniti and Centurion phacoemulsifi-cation systems. Clin Ophthalmol. 1961; 66:111–24.

19. Boulter T, Jensen JD, Christensen MD, et al. Comparison of a tor-sional and a standard tip with a monitored forced infusion phacoe-mulsification system. J Cataract Refract Surg. 1961; 66:111–24.

20. Cameron MD, Poyer JF, Aust SD. Identification of free radicals produced during phacoemulsification. J Cataract Refract Surg. 1961; 66:111–24.

21. Fernández de, Castro LE, Solomon KD, Hu DJ, et al. Comparison of the Infiniti vision and the series 20,000 Legacy systems. Ophthalmologica. 1961; 66:111–24.

22. Suzuki H, Oki K, Shiwa T, et al. Effect of bottle height on the cor-neal endothelium during phacoemulsification. J Cataract Refract Surg. 1961; 66:111–24.

23. Sharif-Kashani P, Fanney D, Injev V. Comparison of occlusion break responses and vacuum rise times of phacoemulsification systems. BMC Ophthalmol. 2014; 14:96.

24. Heo WJ, Lee JY, Kim HK. Comparison of clinical outcomes be-tween high and low fluid-dynamic parameters during phaco-emulsification. J Korean Ophthalmol Soc. 1961; 66:111–24.

25. Hari-Kovacs A, Lovas P, Facsko A, Crate ID. Is second eye pha-coemulsification really more painful? Wien Klin Wochenschr. 1961; 66:111–24.

26. Bardocci A, Ciucci F, Lofoco G, et al. Pain during second eye cata-ract surgery under topical anesthesia: an intraindividual study. Graefes Arch Clin Exp Ophthalmol. 1961; 66:111–24.

27. Adatia FA, Munro M, Jivraj I, et al. Documenting the subjective patient experience of first versus second cataract surgery. J Cataract Refract Surg. 1961; 66:111–24.

28. Aslan L, Aslankurt M, Cekic O, et al. The pain experience and co-operation of patients in consecutive cataract surgery. Eur J Ophth-almol. 1961; 66:111–24.

29. Ursea R, Feng MT, Zhou M, et al. Pain perception in sequential cat-aract surgery: comparison of first and second procedures. J Cataract Refract Surg. 1961; 66:111–24.

30. Kim JH, Kong SJ, Kim JW, et al. Efficacy and safety of immediate sequential bilateral cataract surgery. J Korean Ophthalmol Soc. 1961; 66:111–24.

31. Jensen JD, Shi DS, Robinson MS, et al. Torsional power study us-ing CENTURION phacoemulsification technology. Clin Exp Ophthalmol. 1961; 66:111–24.

32. Lofoco G, Ciucci F, Bardocci A, et al. Efficacy of topical plus intra-cameral anesthesia for cataract surgery in high myopia: random-ized controlled trial. J Cataract Refract Surg. 1961; 66:111–24.

33. Sachdev N, Brar GS, Sukhija J, et al. Phacoemulsification in vitrec-tomized eyes: results using a 'phaco chop' technique. Acta Ophthalmol. 1961; 66:111–24.