Evaluating The Effect Of Low Iop Fluidic Settings On Postoperative Corneal Parameters In Cataract Surgery In Pseudoexfoliation Syndrome

This study aimed to compare the effects of low and standard fluidic settings during phacoemulsification on postoperative corneal and refractive parameters in patients with pseudoexfoliation syndrome underwent cataract surgery.

This study was conducted at the Ankara Bilkent City Hospital, Department of Ophthalmology

In this prospective, randomized clinical study conducted at Ankara Bilkent City Hospital, cataract surgery was performed on one eye of 60 age-matched patients using the phacoemulsification technique.Patients were divided into two groups:the low fluidic settings group 30–40 mmHg)and the standard fluidic settings group(50–60 mmHg).Preoperative and postoperative assessments included best-corrected visual acuity(BCVA),intraocular pressure(IOP),central corneal thickness (CCT),endothelial cell density(ECD),coefficient of variation(CV),hexagonality(HEX).Final postoperative measurements were recorded at one month.Additionally, cumulative dissipated energy (CDE),aspiration time,balanced salt solution(BSS)volume used intraoperatively were documented.

A total of 60 patients were included, with 30 in each group. Postoperative evaluations on day 1, week 1, and month 1 showed no significant differences between the groups in terms of BCVA, IOP, CCT, ECD, CV, or HEX.(p>0.05)

The mean intraoperative BSS volume was 38.2 ± 5.8 mL in the standard fluidic settings group and 37.3 ± 6.3 mL in the low fluidic settings group.(p<0.001) The CDE values were 7.9 ± 2.4 in the standard fluidic settings group and 7.7 ± 2.2 in the low fluidic settings group. (p<0.002) Aspiration times were similar between groups (95.3 ± 21.0 seconds vs. 95.4 ± 27.0 seconds). (p=0.009)

This study demonstrates that phacoemulsification can be safely performed with low fluidic settings and low intraoperative IOP, even in challenging pseudoexfoliation cases. Given the potential optic nerve head circulation impairment in these patients, maintaining low IOP during surgery may be a beneficial approach to minimize additional stress on the optic nerve. Our findings support low-fluidic phaco as a safe and effective option for pseudoexfoliation syndrome.