Comparison between Active and Gravity-based Phacoemulsification Fluidics Systems in Immediate Sequential Bilateral Cataract Surgery

Seok Joon Kong; Cheolwon Jang; Tae Hyung Lim; Kee Yong Choi; Beom Jin Cho

doi:10.3341/jkos.2017.58.1.27

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Kong, Jang, Lim, Choi, and Cho: Comparison between Active and Gravity-based Phacoemulsification Fluidics Systems in Immediate Sequential Bilateral Cataract Surgery

Original Article

J Korean Ophthalmol Soc 2017;58(1):27-33.

Published online: 30 August 2017

DOI: https://doi.org/10.3341/jkos.2017.58.1.27

Comparison between Active and Gravity-based Phacoemulsification Fluidics Systems in Immediate Sequential Bilateral Cataract Surgery

Seok Joon Kong, M.D, Cheolwon Jang, M.D, Tae Hyung Lim, MD, PhD, Kee Yong Choi, MD, PhD, Beom Jin Cho, MD, PhD

HanGil Eye Hospital, Incheon, Korea

￭ Address reprint requests to Beom Jin Cho, MD, PhD HanGil Eye Hospital, #35 Bupyeong-daero, Bupyeong-gu, Incheon 21388, Korea Tel: 82-32-503-3322, Fax: 82-32-504-3322 E-mail: chobjn@empas.com

Received 18 August 201623 November 2016 Accepted 28 December 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the clinical outcomes during phacoemulsification when using active fluidics (Centurion^®) and grav-ity-based fluidics (Infiniti^®) in immediate sequential bilateral cataract surgery.

Methods

From January 2015 to September 2015, 68 eyes of 34 patients with bilateral cataract were assigned to receive imme-diate sequential bilateral cataract surgery by Centurion^® in one eye and Infiniti^® in the other eye. We measured and compared in-traoperative factors, including cumulative dissipated energy (CDE), ultrasound time, mean amount of balanced salt solution (BSS) used, and pain using a scale. Best corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell density (ECD) were also evaluated preoperatively and 1 month postoperatively.

Results

Intraoperative measurements showed significantly less CDE (5.05 ± 2.18 vs. 7.05 ± 3.82), ultrasound time (24.65 ± 9.68 vs. 34.95 ± 17.95 seconds), and mean amount of BSS used (37.06 ± 10.25 vs. 44.88 ± 16.38 mL) in the Centurion^® group than in the Infiniti^® group ( p = 0.011, p = 0.005, p = 0.021, respectively). The intraoperative pain scale was 0.26 ± 0.51 in the Centurion^® group and 0.50 ± 0.71 in the Infiniti^® group, and was not significantly different ( p = 0.121). BCVA, increase of CCT and decrease of ECD were not significantly different between the two groups at 1 month postoperatively.

Conclusions

The efficacy of phacoemulsification in the Centurion^® group was superior to that in the Infiniti^® group. The level of intraoperative pain and clinical outcomes 1 month after surgery were not significantly different between the two groups.

Keywords: Active fluidics, Cumulative dissipated energy, Gravity-based fluidics, Immediate sequential bilateral cataract surgery, Pain

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Table 1.

Patient baseline characteristics

Centurion^®	Infiniti^®	p-value^*
Eyes	34	34
Age (years)	65.2 ± 11.9	65.2 ± 11.9
Sex (male:female)	10:24 (n = 34)	10:24 (n = 34)
Lens opacity
Nuclear opalescence	2.11 ± 0.81	2.14 ± 0.82	0.882
Nuclear color	2.11 ± 0.81	2.14 ± 0.82	0.882
BCVA (logMAR)	0.27 ± 0.20	0.27 ± 0.22	0.959
Axial length (mm)	23.76 ± 1.45	23.76 ± 1.48	0.991
Anterior chamber depth (mm)	2.68 ± 0.51	2.69 ± 0.48	0.905
Central corneal thickness (μ m)	532.82 ± 28.20	534.44 ± 30.74	0.822
Endothelial cell density (cells/mm²)	2531.2 ± 267.9	2599.3 ± 237.5	0.271

Values are presented as mean ± SD unless otherwise indicated. BCVA = best corrected visual acuity.

^* Student’s t-test.

Table 2.

Comparison of intraoperative parameters and pain scale between the Centurion® and Infiniti® group

	Centurion®	Infiniti®	p-value^*
CDE	5.05 ± 2.18	7.05 ± 3.82	0.011
Ultrasound time (sec)	24.65 ± 9.68	34.95 ± 17.95	0.005
Total used BSS volume (mL)	37.06 ± 10.25	44.88 ± 16.38	0.021
Pain scale	0.26 ± 0.51	0.50 ± 0.71	0.121

Values are presented as mean ± SD unless otherwise indicated. CDE = cumulative dissipated energy; BSS = balanced salt solution.

^* Student’s t-test.

Table 3.

Comparison of postoperative outcomes between the Centurion® and Infiniti® group at postoperative 1 month

	Centurion®	Infiniti®	p-value^*
BCVA (logMAR)	0.042 ± 0.056	0.040 ± 0.062	0.880
Increase of CCT (%)	0.51 ± 2.87	0.27 ± 2.29	0.697
Decrease of ECD (%)	7.00 ± 9.73	7.75 ± 10.66	0.761

Values are presented as mean ± SD unless otherwise indicated. BCVA = best corrected visual acuity; CCT = central corneal thickness; ECD = endothelial cell density.

^* Student’s t-test.

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