Surgical techniques yield less change after phacoemulsification

November 15, 2011

A lower aspiration flow rate and lower bottle height result in better outcomes after phacoemulsification.

Ahmedabad, India-A lower aspiration flow rate and lower bottle height result in better outcomes after phacoemulsification. Researchers reported less increase in the central corneal thickness (CCT), clearer corneas, and decreased inflammation of the anterior segment shortly after surgery.

Dr. Vasavada and colleagues evaluated the effects of different fluidic parameters on the fluctuations in IOP during phacoemulsification in a previous study and found that the IOP fluctuations are lower in association with lower fluidic parameters.

The prospective, randomized, masked study included 50 patients undergoing extraction of age-related cataracts using longitudinal ultrasound; 25 patients were randomly assigned to group 1 that was treated with low fluidic parameters (flow rate, 25 ml/minute; bottle height, 70 and 90 cm; and vacuum up to 400 mm Hg), and 25 patients were randomly assigned to group 2 that was treated with high fluidic parameters (flow rate, 40 ml/minute; bottle height, 90 and 110 cm; and vacuum up to 650 mm Hg). One surgeon performed all standard phacoemulsification procedures. All surgeries were performed on a proprietary phacoemulsification platform (Infiniti Vision System, Alcon Laboratories) using a standardized surgical technique. The ophthalmic viscosurgical devices used were chondroitin sulfate 4%/sodium hyaluronate 3% (Viscoat, Alcon) and sodium hyaluronate 1% (ProVisc, Alcon) with the soft-shell technique.

Dr. Vasavada evaluated the intraoperative parameters of cumulative dissipated energy, surgical time, and the amount of fluid used. The postoperative parameters evaluated included changes in CCT at various time points, percentage changes in endothelial cell density (ECD) 3 months postoperatively, anterior segment inflammation on day 1, and corneal clarity on day 1.

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