J Korean Ophthalmol Soc.  2018 Nov;59(11):1017-1023. 10.3341/jkos.2018.59.11.1017.

Clinical Effects of an Improved Pump Reaction Rate and Automatic Occlusion Sensing System in Phacoemulsification

• Kim YN
• Lee JA
• Kim JY
• Kim MJ
• Tchah HW

• KMID: 2426362
• DOI: http://doi.org/10.3341/jkos.2018.59.11.1017

Abstract

PURPOSE
A recently introduced phacoemulsification system, the WhiteStar Signature® PRO, has demonstrated improved nucleus followability and cutting efficiency via an improved pump regulator with a higher reaction response and an automatic occlusion sensing system. In this study, we compared various phacoemulsification parameters between the new system and an older version of the device.
METHODS
A total of 80 eyes of 68 patients with cataracts who had undergone phacoemulsification by a single surgeon were included in this study. Forty eyes of patients underwent phacoemulsification using the older Signature® system (WhiteStar); these patients were classified as the control group. Another 40 eyes of patients underwent phacoemulsification with the newer enhanced system, the WhiteStar Signature® PRO; these patients were assigned to the experimental group. During the operation, operative parameters, including the effective phaco time (parameter of effective phaco time with a specific coefficient for the transversal movement expressed in seconds, EFX), ultrasound time (seconds [s]), effective phacoemulsification time (EPT, s), average phacoemulsification power (AVG, %), and balanced salt solution usage, were measured to determine the performance enhancement offered by the updated system. Central corneal thickness was measured before and after surgery to compare corneal edema. The relationships between the two groups were analyzed using an independent t-test.
RESULTS
The Signature PRO® system showed a lower EFX (p < 0.001), a shorter EPT (p < 0.001), and a smaller AVG (p < 0.001). Postoperative corneal thickness did not differ significantly between the two groups.
CONCLUSIONS
Comparing the efficacy of the improved reaction speed of the device and automatic occlusion sensing system in performing phacoemulsification, the updated Signature PRO® system demonstrated superior followability and cutting efficiency regardless of nuclear cataract hardness.

Keyword

Automatic occlusion sensing; Central corneal thickness; Effective phacoemulsification time; Handpiece

MeSH Terms

Cataract
Corneal Edema
Hardness
Humans
Phacoemulsification*
Ultrasonography

Figure

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  Figure 1. Change of preoperative and post-operative central corneal thickness (CCT) (μ m). This graph features changes of CCT between two phacoemulsification systems. A solid line shows the mean CCT values in the group using enhanced device group (Signature PRO® system) and a dotted line shows the mean CCT values in the control group (Signature® system). Using independent t-test, there is no statistically significant difference between two systems (p > 0.05) in total and subgroup analysis. (A) Total group. (B) Soft nucleus subgroup. (C) Hard nucleus subgroup. Preop = pre-operative examination; POD = post-operative day; w= week; mo = month.

Reference

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