Comparison Of Intraoperative Parameters Between Two Different Handpieces In One-Handed Phacoemulsification With Active Fluidics

Published 2024 - 42nd Congress of the ESCRS

Reference: PO522 | Type: Free paper | DOI: 10.82333/2gvp-rg20

Authors: Lucia Del Carmen Gabian Fortes* ¹ , Oscar Guerrero Berger ²

¹Anterior Segment,Fundación Hospital Nuestra Señora de la Luz IAP,Mexico City,Mexico;Uveitis,Fundación Hospital Nuestra Señora de la Luz IAP,Mexico City,Mexico, ²Anterior Segment,Fundación Hospital Nuestra Señora de la Luz IAP,Mexico City,Mexico

Purpose

To compare anterior chamber stability and surgical efficiency in one-handed phacoemulsification using the Ozil and Active Sentry handpieces

Setting

The absence of anterior chamber leakage characterizes one-handed phaco, maintaining a constant hydrodynamic pressure. Followability is an essential element to maintain surgical efficiency. Centurion Vision System includes the Active Sentry handpiece, which has an integrated pressure sensor, allowing better control of intraoperative pressure and having a faster response for mantaining a lower intraoperative pressure. Intraoperative parameters have not been evaluated in one-handed phaco technique.

Methods

Observational, analytic, comparative and prospective study

Methodology: Selected patients underwent one-handed phacoemulsification surgery and were divided into two groups: Active Sentry and Ozil. Fixed parameters during surgeries (IOP by quadrants, vacuum, and aspiration flow)

Sample: Cohen's formula with an Alpha error of 0.05 and a power of 80%. N= 60 (30 eyes per group)

Statistical analysis: Mean + SD for continuous variables and frequencies for categorical variables. Between-group comparisons: independent t tests or Mann-Whitney U tests. A 2-sided p-value will be considered statistically significant

Endpoints: Intraoperative anterior chamber instability score (IACIS), Cumulative dissipated energy (CDE), Followability and Surgery duration

Results

Mean age 71.42 in Active Sentry Group and 73.97 in Ozil Group. Mean Axial Lenght 22.85+ 1.21 in Actuve Sentry vs 23.3 + 1.29 in Ozil Group. Intraoperative anterior chamber instability score 0.10 + 0.30 in Active Sentry vs 0.63 + 0.71 in Ozil Group with p value < 0.001 having a statistically significant difference between groups. Cummulative dissipated energy 9.95 + 4.76 in Active Sentry vs 10.89 + 6.55 in Ozil with p value

0.519, Followability score 0.74 + 0.855 in Active Sentry vs 0.83 + 0.874 in Ozil with p value 0.678 and Surgery duration 19.00 + 5.44 in Active Sentry vs 24.57 + 6.51 in Ozil with p value < 0.001 statistically significant difference between groups

Conclusions

•The Active Sentry handpiece improves anterior chamber stability in one-handed phacoemulsification, demonstrated by the IACI score.

•There were no differences in followability between groups, indicating that the Active Sentry handpiece maintains surgical performance during nucleus removal without an auxiliary side-port.

•Improved AC stability and preservation of followability (compared to conventional phaco)reduced surgery duration.

•To the best of our knowledge, this is the first study demonstrating that the Active Sentry handpiece can increase AC stability not only in conventional phacoemulsification but also in one-handed phacoemulsification.