Power game in phacoemulsification

Poster Details

First Author: D.Nath INDIA

Co Author(s):    K. Sambhav   K. Krishna           

Abstract Details

Purpose:

To evaluate the variability of phaco power in same hardness of cataract

Setting:

Geeta Netra Chikitsalaya, a rural eye care setting in northern – central India

Methods:

Retrospective analysis of medical records of all patient undergoing phacoemulsification cataract surgeries from 1st Jan 2010 to 31st Dec 2011. From all patients written informed consent was taken before surgery and were explained about the risk and benefits associated. Complete data in relation to demographic profile of patient, hardness of cataract, phaco time(EPT – Elapsed phaco time & APT – Absolute phaco time), type of phaco technique used and phaco settings were documented. Patients having associated ocular problem which might impair the visual outcome (diabetic retinopathy, glaucoma, corneal scar, macular dysfunctions) were excluded. All patients undergoing combined surgeries were also excluded. Detained analysis was done comparing phaco time needed for a specific grade of cataract in relation to the mode of phaco used. Especial attention was given to mode of phaco used (Continuous, pulse, waveform, burst). All the surgeries were done by single operating surgeon and with use of same operating machine. Machine used of all the surgeries was Stellaris (Bausch & Lomb).

Results:

Total of 5848 eyes of 3718 patients were included in the study. Of the 3718 patients 2163 were males and the rest were females. Of 5848 eyes, 848 eyes were of grade I cataract, 1534 eyes were having grade II cataract, 2160 eyes were having Grade III cataract and 694 eyes were having Grade IV/V cataract. Continuous phaco was used in 330 cases, pulse mode was used in 3484 patients, Waveform was used in 565 patients and burst mode was used in 1469 cases. EPT and APT were variable for the cases. Average EPT was 3 min & average APT was 24 sec. Data had non parametric distribution. Kruskal Wallis test was used comparing grade of nuclear hardness, phaco mode and phaco time. In continuous mode average EPT was 2.2 min and average APT was 30 sec. In pulse mode average EPT was 3 min and APT was 20 sec. In pulse mode average EPT was 4 min and APT was 15 sec. In burst mode average EPT was 4 min and APT was 25 sec.

Conclusions:

In our cohort of 5848 patients we concluded that EPT Increases from continuous to pulse to waveform mode of phaco but the APT decreases. We also concluded that for grade I cases Waveform is the best mode utilizing least absolute phaco time. For grade II/ III cases hyper pulse High vacuum phaco mode is ideal and for hard cataracts burst mode should be used FINANCIAL DISCLOSURE?: No