The Cutting Efficiency of a Hybrid Phacoemulsification Tip Using High and Low Intraocular Pressure Settings in Different Grades of Cataract.

Purpose: To evaluate the efficiency of a hybrid tip in removing cataract grade 3 and 4 in high and low intraocular pressure (IOP) settings.

Methods: This was a randomized, prospective, double-arm contralateral eye study. One randomized eye of each subject had phacoemulsification with high IOP settings (50 mmHg) while the other eye had phacoemulsification with low IOP settings (20 mmHg). Operative endpoints included phaco time, aspiration time, fluid use, cumulative dissipated energy (CDE), total case time, total torsional time, and total longitudinal time. Postoperative endpoints included central corneal thickness (CCT), and IOP.

Results: A total of 102 eyes (51 patients) completed the study. Phaco time in grade 3 and grade 4 cataracts were 38.4 ± 9.6 s and 44.1 ± 9.9 s in the high group, respectively, and 38.9 ± 8.6 s and 46.3 ± 11.0 s in the low group, respectively. Aspiration time in grade 3 and grade 4 cataracts were 95.3 ± 21.2 s and 111.8 ± 32.8 s in the high group, respectively, and 105.4 ± 27.0 s and 108.6 ± 23.1 s in the low group, respectively. Fluid volume used in grade 3 and grade 4 cataracts were 39.2 ± 6.8 mL and 45.2 ± 10.8 mL in the high group, respectively, and 38.3 ± 7.3 mL and 43.2 ± 8.0 mL in the low group, respectively. The CDE in grade 3 and grade 4 cataracts were 7.8 ± 2.6 and 10.2 ± 3.2 in the high group, respectively, and 7.7 ± 2.2 and 9.9 ± 4.5 in the low group, respectively.

Conclusion: Results suggest that a hybrid phacoemulsification tip was efficient in removing cataracts of grade 3 and grade 4 with high and low IOP settings.