Real-time dynamic changes in intraocular pressure after occlusion break: comparing 2 phacoemulsification systems

Area of Science:

• Ophthalmology
• Surgical Technology
• Biomedical Engineering

Background:

• Cataract surgery involves phacoemulsification, a process susceptible to intraocular pressure (IOP) fluctuations.
• Occlusion break events during phacoemulsification can lead to significant IOP surges, potentially impacting surgical outcomes.
• Real-time IOP monitoring and response are crucial for maintaining ocular stability during surgery.

Purpose of the Study:

• To compare the real-time intraocular pressure (IOP) response to occlusion break events between two phacoemulsification systems.
• To evaluate the efficacy of the Centurion Vision system with Active Sentry upgrade versus the traditional handpiece in managing IOP fluctuations.
• To assess the speed of IOP recovery and the extent of IOP reduction during nuclear fragment removal.

Main Methods:

• A randomized experimental study was conducted on rabbits (20 eyes).
• Two groups were established: Group I (Centurion Vision with active fluidics) and Group II (Centurion with Active Sentry).
• Two parameter sets were tested, varying IOP, aspiration flow rate (AFR), and vacuum levels, with real-time IOP changes recorded after occlusion breaks.

Main Results:

• The rate of IOP drop after occlusion break did not differ significantly between the groups.
• The rate of IOP rise to baseline was significantly faster in the Centurion with Active Sentry group (Group II) for both parameter sets.
• The mean percentage reduction of IOP from maximum during nuclear fragment removal was significantly higher in the traditional Centurion Vision system group (Group I).

Conclusions:

• The Centurion Vision system with the Active Sentry upgrade facilitates a faster IOP rise to baseline following occlusion break events.
• This upgrade leads to a lower mean percentage reduction of IOP during nuclear fragment removal, indicating improved IOP stability.
• The Active Sentry's ability to sense IOP at the handpiece level enables quicker mitigation of surge responses, enhancing surgical safety.