Posters

Optimizing phacoemulsification parameters through sequential CDE and pachymetry measurements in cataract surgery

Poster Details

First Author: S.Sayegh USA

Co Author(s): A. Al-Heeti   E. Cotton                 

Abstract Details

Purpose:

To present a methodology to improve outcomes through a systematic reduction in cumulative dissipated energy (CDE) at the time of phacoemulsification in cataract surgery.

Setting:

Private clinic and 5 surgical theaters with a single surgeon using same surgical platforms with coordinated settings.    Follow up at clinic with identical devices to perform objective measurements.

Methods:

The divide and conquer method was used for the vast majority of the 100 cases analyzed.  The CDE was recorded separately for the sculpt phase and the quadrant emulsification phase of the procedure.  This was also done for a dense cataract setting and a hybrid setting.   Postoperative examination included OCT pachymetry at one day, one week and one month following the procedure. Comparison of the CDE for the two phases of the procedure were performed and correlations with the resulting percent change in pachymetry analyzed.

Results:

The CDE distribution varied but a larger fraction was typically assigned to the sculpting phase of the procedure.   As expected percent change in corneal pachymetry was highly correlated with total CDE.    The dense mode often produced an equivalent or lower CDE contribution.   There was a very weak correlation with a higher degree of “chopping” with decreased CDE.  The hybrid approach presented clear advantages in terms of reducing CDE and degree of corneal edema postoperatively.

Conclusions:

There is a large variety of settings used by different surgeons and these are often routinely used after initial set up for operating thousands of cases before adjustment are made.   The methodology presented allows for a refined analysis of phacoemulsification methods and improved patients outcomes.   In particular it allows the introduction of hybrid methods that minimize CDE and postoperative edema in cataract surgery by phacoemulsification and can be applied to a variety of surgical platforms.

Financial Disclosure:

None