Utility of centralised cloud-based parameter database for setting optimisation for vacuum-based phacoemulsification surgery

Session Details

Session Title: Combined Cataract Surgery & Practice Styles

Session Date/Time: Sunday 15/09/2019 | 14:00-16:00

Paper Time: 15:46

Venue: Free Paper Forum: Podium 2

First Author: : V. Kolesnitchenko USA

Co Author(s): :    M. Shultz    G. Lau   A. Pilon                       

Abstract Details

Purpose:

To evaluate correlation between fluidics profile and ultrasound utilization across varing presumed nuclear densities during routine cataract removal using centralized data collected at the time of surgery from multiple devices

Setting:

Physician owned and operated Ambulatory Surgery Center (ASC). Freedom Vision Surgical Center, Encino, CA, USA

Methods:

A single surgeon, retrospective, non-randomized, consecutive eyes study. LOCS III grading was perform preoperatively with majority falling into 2+ (N=37), 3+ (N=65) and 4+ (N=34). All surgeries were performed with a dual-linear vacuum-based phacoemulsification adaptive fluidics system, matching settings with nuclei densities. Detailed fluidics and ultrasound utilization data were captured and uploaded to the cloud for subsequent statistical analysis (ANOVA). Parameters evaluated include: Infusion Actual Time (IAT), Infusion Average Pressure (IAP), Aspiration Actual Time (AAT), Aspiration Average Vacuum (AAV), Aspiration Effective Vacuum Time (AEVT), Ultrasound Actual Time (UAT), Ultrasound Average Power (UAP) and Ultrasound Effective Time (UET)

Results:

The study demonstrated a very strong correlation of fluid utilization with average IAT (minutes) at 2.86, 2.97 and 3.74 (p=0.00), average AAT (minutes) at 2.15, 2.25 and 2.83 (p=0.00) and average AEVT (minutes) at 0.94, 1.05 and 1.27 (p=0.00), as well as, ultrasound utilization with average UAT (seconds) at 2.80, 6.17 and 24.02 (p=0.00), UAP (%) at 12.18, 13.27 and 18.74 (p=0.00) and average UET (sec) at 0.35, 0.82 and 4.72 (p=0.00). IAP (mmHg) was lower for the 4+ group (85.54, 85.88 and 74.68; p=0.00) and AAV was elevated for the 3+ group (262.85, 281.41 and 268.71; p=0.03)

Conclusions:

Cloud-Based, parameter databases allow for setting optimization for vacuum-based phacoemulsification surgery as demonstrated by matching nuclei density scores with fluidics and ultrasound profiles. Deeper data segmentation by surgical phasing and a larger sample size will be instrumental in demonstrating the capacity of this medium to improve surgical efficiency and safety during routine cataract surgery.

Financial Disclosure:

is employed by a for profit company with an interest in the subject of the presentation, receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented