Comparison of two torsional phacoemulsification technologies in varying grades of cataract: active fluidics vs gravity based Irrigation

Session Details

Session Title: Cataract Surgery Complications Management. OVDs, Cataract Surgery Equipment

Session Date/Time: Monday 07/09/2015 | 08:00-10:00

Paper Time: 09:15

Venue: Main Auditorium

First Author: : N.Shroff INDIA

Co Author(s): :    R. Dutta   A. Koul                 

Abstract Details

Purpose:

To evaluate the safety profile, effectiveness and visual outcome of Active Fluidics technology of the Centurion Vision System (Alcon) versus the Gravity based irrigation system of the Infiniti Vision System (Alcon) in varying grades of cataracts.

Setting:

Cataract & Intraocular Lens Implantation Service, Shroff Eye Centre, New Delhi, India.

Methods:

200 eyes with nuclear sclerosis grade-2 to grade-4, endothelial cell density > 1800/mm2, with no other ocular pathology underwent phacoemulsification utilizing Centurion Vision System with Intrepid Balanced Tip (100 eyes) and Infiniti Vision System with 0.9 mm 45° Kelman tip (100 eyes). Intraoperative parameters studied were Cumulative Dissipated Energy (CDE) in both groups, irrigating fluid volume, nuclear fragment followability, chamber stability and any intra-operative complication. All eyes were examined postoperatively at day-1, day-7, and day-30 for central corneal thickness (CCT), anterior chamber reaction and best-corrected visual acuity (BCVA). Endothelial cell density (ECD) with specular microscopy was done at 3 months.

Results:

Mean CDE was 8.82±4.43 and 15.88±8.03 in the Centurion and the Infiniti group respectively (p<0.001). Mean irrigating fluid volume (mL) was 81.2±35.8 and 106.8±14.4 for Centurion and Infiniti groups respectively (p<0.001). LogMAR BCVA on day-1 was 0.13±0.14 and 0.21±0.16 for Centurion and Infiniti groups respectively (p=0.038). LogMAR BCVA on day-30 was -0.02 ± 0.15 and -0.02 ± 0.18 in Centurion and Infiniti groups respectively (p>0.05). CCT on day-1 and day-7 was 552.3±51.4µ and 545±37.0µ in the Centurion group, and 576.8±48.5µ and 550.6±47.4µ in the Infiniti group respectively (p=0.042 day-1, and p>0.05 day-7). Anterior chamber reaction showed no significant difference in the two groups. ECD (3 months) was 2185.2±285.8 cells/mm2 and 2159.3±435.8 cells/mm2 in the Centurion and Infiniti groups respectively (p=0.029).

Conclusions:

The newer activefFluidics of the centurion provides better chamber stability at higher flow rates and vacuum as well as lower and safer IOPs for the optic nerve head than gravity fed systems. The Centurion Vision System uses less fluid and energy during surgery, provides quicker vision rehabilitation with clearer corneas on post-operative day-1, and leads to less endothelial cell loss in the long-term.

Financial Interest:

NONE