Clinical Ophthalmology (Nov 2024)
The Cutting Efficiency of a Hybrid Phacoemulsification Tip Using High and Low Intraocular Pressure Settings in Different Grades of Cataract
Abstract
Justin Spaulding,1 Brad Hall2 1Cataract & Laser Institute, Medford, OR, USA; 2Sengi, Penniac, NB, CanadaCorrespondence: Justin Spaulding, Cataract & Laser Institute, 1408 E Barnett Road, Medford, OR, 97504, USA, Tel +1-541-779-2020, Email [email protected]: 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.Plain Language Summary: Phacoemulsification involves emulsifying the natural lens during cataract surgery with an ultrasonic handpiece and removing the lens from the eye. An important facet for safety and good postoperative outcomes is the phacoemulsification tip. Traditional tips have used a metal cutting edge. A new hybrid tip is available that utilizes a soft polymer on the metal tip. The purpose of this study was to assess the efficiency of the hybrid tip to remove different grades of cataract. The results of this study suggest that a hybrid tip was efficient in removing grade 3 and grade 4 cataracts at both low and high intraocular pressure settings.Keywords: active sentry, phacoemulsification, intrepid hybrid
