Comparative Analysis Of The Efficiency Of Two Different Procedures For Cataract Removal By Phacoemulsification. Alcon Centurion Vs Alcon Centurion With Active Sentry Handpiece.

In this study we want to evaluate the role of fluidics in the ALCON phacoemulsifier (CENTURION) analized in two configurations, namely in Active Fluidic mode and in Active Fluidic mode with an Active Sentry handpiece, equipped with a sensor for continuous pressure control in the anterior chamber. The purpose of the study is to analyze and to compare the efficiency of each phaco system (device dedicated to cataract removal) by evaluating the different parameters related to fluidics like Intra Ocular Pressure (IOP), Estimated Aspirated Fluid, Total Aspiration Time,  and related to ultrasound like Total Ultrasound Time, Cumulative Dissipated Energy (CDE) and Mean Equivalent Ultrasound Time.

“Mediterranea” Clinic 

Ophthalmology Operative Unit of the “Mediterranea” Clinic 

Via Orazio, 2 – 80122 Napoli (Italy)

Eighty-seven nonconsecutive patients were submitted to cataract extraction by phacoemulsification technique using the Alcon Centurion. Patients enrolled in the study have grade 3 cataract according to the LOCS grading system to avoid differences of cataract between the different groups. The Centurion phacoemulsifier was evaluated in the two configurations, namely in Active Fluidic mode and in Active Fluidic mode with an Active Sentry handpiece, equipped with a sensor for continuous pressure control. In the Centurion group 50 patients were enrolled and 37 in the Sentry Group.  We compared the total Ultrasound Time (US Time), Cumulative Dissipated Energy (CDE), Total Aspiration time, Estimated Aspirated Fluid and Mean Equivalent US Power. 

The statistical analysis has been evaluated by T-student test for independent samples using the Levine test for variance of homogeneous populations, and the 95% confidence interval is indicated. Total US time is 30.61sec ± 9,25 in the Centurion Group and 29,47sec ± 9,74 in the Sentry Group. ECD is 4,71 ± 1,92 in the Centurion Group and 4,51 ± 1,76 in the Sentry group. Estimated Aspirated Fluid is 51,34cc ± 9,67 in the Centurion Group and 49,68cc ± 12,01 in the Sentry Group. Mean equivalent US power is 10,54%±2,57 in the Centurion Group and 10,21%±2,28 in the Sentry group. No statistical difference between the two groups has been found. 

The Centurion system in the Sentry configuration presents comparable efficiency respect to the Standard Centurion Configuration in cataract removal. The Active Sentry handpiece with the continue pressure control allows a lower IOP cataract surgery (20mmHg in the Sentry group respect to 26mmHg in the Centurion group) with comparable safety and comparable efficiency of the Centurion in the Standard configuration, with non-statistical difference in energy delivered and use of fluid for the cataract removal. ECD and total US time showed lower mean value in the Sentry group respect to the Centurion group with lower energy and lower fluid needed to remove cataract with a lower IOP set for the cataract removal yet non-statistically significant.