Intraoperative Performance and Early Postoperative Outcomes Following Phacoemulsification With Three Fluidic Systems: A Randomized Trial.

IF 2.9 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery Pub Date : 2024-05-01 DOI:10.3928/1081597X-20240314-02

Vaishali Vasavada, Deepa Agrawal, Shail A Vasavada, Abhay R Vasavada, Jignasu Yagnik

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Abstract

Purpose: To compare intraoperative performance and early postoperative outcomes following phacoemulsification with two systems using active fluidics and one using gravity-based fluidics.

Methods: In this prospective randomized trial, 200 eyes were randomized to the traditional and Active Sentry groups (n = 80 eyes each) where the Centurion Vision System was used with traditional or Active Sentry (Alcon Laboratories, Inc) hand-pieces, respectively, or the Infinit group (n = 40 eyes) where the Infiniti Vision System (Alcon Laboratories, Inc) was used. Within the traditional and Active Sentry groups, there were two subgroups with low (30 mm Hg) or high (55 mm Hg) intraocular pressure (IOP) used. Outcome measures compared were: cumulative dissipated energy (CDE), percentage change in central corneal thickness (CCT) at 1 day, 1 week, and 1 month, anterior chamber cells at 1 day and 1 week, rate of rise and fall of IOP following occlusion break, corneal endothelial cell density (ECD), and macular thickness 6 months postoperatively.

Results: CDE was significantly lower in group II compared to the traditional group (2.96 ± 1.4 vs 4.14 ± 2.2, P = .001). With 30 mm Hg IOP, the Active Sentry group had significantly less percentage change in CCT at 1 week postoperatively compared to the traditional handpiece group (0.01% vs 0.02%, P = .008). Incidence of anterior chamber cells less than grade 2 on day 1 was significantly higher in the Active Sentry group (82.9% vs 52%, P = .03). Percentage change in ECD was significantly lower in the Active Sentry group (-0.957 vs -0.98%, P = .005). Significantly faster rise of IOP to baseline following occlusion break was seen in the Active Sentry group.

Conclusions: The use of Active Sentry handpiece was associated with lower CDE, less postoperative increase in CCT, fewer anterior chamber cells, and faster rise of IOP following occlusion break. [J Refract Surg. 2024;40(5):e304-e312.].

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使用三种液体系统进行超声乳化术的术中表现和术后早期疗效：随机试验。

目的：比较两种主动流体力学系统和一种重力流体力学系统进行超声乳化术后的术中表现和早期术后效果：在这项前瞻性随机试验中，200 只眼睛被随机分为传统组和主动哨兵组（每组 n = 80 只眼睛），分别使用 Centurion 视觉系统和传统或主动哨兵（Alcon Laboratories, Inc）手钳；或 Infinit 组（n = 40 只眼睛），使用 Infiniti 视觉系统（Alcon Laboratories, Inc）。在传统组和主动哨兵组中，有两个分组，分别使用低眼压（30 毫米汞柱）或高眼压（55 毫米汞柱）。比较的结果指标包括：累积耗散能量（CDE）、1 天、1 周和 1 个月时角膜中央厚度（CCT）的百分比变化、1 天和 1 周时的前房细胞、闭塞中断后眼压的上升和下降速度、角膜内皮细胞密度（ECD）以及术后 6 个月的黄斑厚度：结果：与传统组相比，第二组的 CDE 明显降低（2.96 ± 1.4 vs 4.14 ± 2.2，P = .001）。在眼压为 30 mm Hg 的情况下，Active Sentry 组术后 1 周的 CCT 百分比变化明显低于传统手机组（0.01% vs 0.02%，P = .008）。主动哨兵组第 1 天前房细胞小于 2 级的发生率明显更高（82.9% vs 52%，P = .03）。主动哨兵组的 ECD 百分比变化明显较低（-0.957 vs -0.98%，P = .005）。主动哨兵组在闭塞断裂后眼压上升至基线的速度明显更快：结论：使用 Active Sentry 手机与较低的 CDE、较少的术后 CCT 增加、较少的前房细胞以及闭塞中断后较快的 IOP 上升有关。[J Refract Surg. 2024;40（5）：e304-e312]。

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来源期刊

$Journal of refractive surgery$

Journal of refractive surgery 医学-外科

CiteScore

5.10

自引率

12.50%

发文量

160

审稿时长

4-8 weeks

期刊介绍： The Journal of Refractive Surgery, the official journal of the International Society of Refractive Surgery, a partner of the American Academy of Ophthalmology, has been a monthly peer-reviewed forum for original research, review, and evaluation of refractive and lens-based surgical procedures for more than 30 years. Practical, clinically valuable articles provide readers with the most up-to-date information regarding advances in the field of refractive surgery. Begin to explore the Journal and all of its great benefits such as: • Columns including “Translational Science,” “Surgical Techniques,” and “Biomechanics” • Supplemental videos and materials available for many articles • Access to current articles, as well as several years of archived content • Articles posted online just 2 months after acceptance.