Unraveling The Influence Of Preoperative And Intraoperative Parameters On Active Surge Mitigation (Asm) Actuations: Optimizing Phacoemulsification With Active Sentry Handpiece
Published 2024 - 42nd Congress of the ESCRS
Reference: PO540 | Type: Free paper | DOI: 10.82333/6kbr-4a61
Authors: Biljana Kuzmanovic Elabjer 1 , Tea Strbac* 2 , Iva Cubela 2 , Benedict Rak 2 , Dora Martincevic 2 , Mladen Busic 1 , Mirjana Bjelos 1
1University Eye Department,University Hospital “Sveti Duh”,Zagreb,Croatia;Faculty of Medicine Osijek,University Josip Juraj Strossmayer in Osijek,Osijek,Croatia;Faculty of Dental Medicine and Health Osijek,University Josip Juraj Strossmayer in Osijek,Osijek,Croatia, 2University Eye Department,University Hospital “Sveti Duh”,Zagreb,Croatia
Purpose
To establish the association of the demographic and biometric factors, nucleosclerosis grade, complications (PEX, IFIS), and intraoperative metrics with Active Surge Mitigation (ASM) actuations in phacoemulsification using Centurion Vision System's Active Sentry handpiece (Alcon Labs).
Setting
A retrospective study was conducted on 146 patients of both genders who underwent phacoemulsification at the University Eye Clinic, University Hospital “Sveti Duh,” Zagreb, Croatia, between February 2023 and October 2023.
Methods
The preoperative analysis included age, gender, biometric data (obtained with Zeiss IOL Master 700 and Oculus Pentacam), and Lens Opacification Classification System (LOCS III) for lens nuclear grade. Consideration of Intraoperative Floppy Iris Syndrome (IFIS) and Pseudoexfoliation Syndrome (PEX) was part of the assessment. Intraoperative metrics during phacoemulsification included total case time, cumulative dissipated energy (CDE), total ultrasound time (U/S time), and the number of active surge mitigation (ASM) actuations. All surgeries were performed with the Active Sentry handpiece of the Centurion Vision System (Alcon Laboratories, Inc) by one skilled surgeon (BKE).
Results
Positive significant correlations were found between ASM and LOCS (P=0.001) and age (P=0.017), while negative correlation with ACD (P=0.005). There were no significant differences in the number of ASM between gender, PEX, and IFIS. In multivariate analysis, ASM ≥ 1 predicts LOCS significantly (OR 1.79, 95% CI 1.04-2.95), while ACD decreases this chance (OR 0.311, 95% CI 0.100-0.960).
Conclusions
Our findings show more ASM actuation in advanced nuclear cataracts and older age, with a deeper anterior chamber linked to significantly fewer actuations than a shallower one. Higher nuclear opacity (NO) has a greater impact on ASM than the anterior chamber depth. Despite expectations, no significant correlation was found between PEX, IFIS, and ASM, likely due to a limited number of subjects with complicating factors.