Comparison of Intraoperative Parameters between Two Handpieces in One-Handed Phacoemulsification with Active Fluidics

Area of Science:

• Ophthalmology
• Surgical Technology
• Cataract Surgery

Background:

• Phacoemulsification is a standard cataract surgery technique.
• Maintaining anterior chamber stability is crucial for safe and efficient cataract surgery.
• One-handed phacoemulsification techniques aim to streamline surgical procedures.

Purpose of the Study:

• To compare anterior chamber stability and surgical efficiency between Ozil and Active Sentry (AS) handpieces during one-handed phacoemulsification.
• To evaluate the impact of the AS handpiece on intraoperative anterior chamber instability score (IACIS), cumulative dissipated energy (CDE), followability, and surgery duration.
• To determine if the AS handpiece offers advantages in one-handed cataract surgery compared to the Ozil handpiece.

Main Methods:

• An observational and comparative study involving patients undergoing one-handed phacoemulsification.
• Patients were divided into two groups using either the AS or Ozil handpiece.
• Standardized parameters including intraocular pressure (IOP) per quadrant, vacuum, and aspiration flow were maintained across all surgeries.

Main Results:

• The Active Sentry (AS) handpiece group demonstrated significantly lower intraoperative anterior chamber instability scores (IACIS) (0.10 ± 0.30) compared to the Ozil group (0.63 ± 0.71) (p < 0.001).
• Surgery duration was significantly shorter in the AS group (19.00 ± 5.44 min) compared to the Ozil group (24.57 ± 6.51 min) (p < 0.001).
• No significant differences were observed in cumulative dissipated energy (CDE) or followability scores between the two handpieces.

Conclusions:

• The Active Sentry (AS) handpiece significantly improves anterior chamber stability during one-handed phacoemulsification.
• The AS handpiece maintains surgical performance during nucleus removal in one-handed phacoemulsification without requiring an auxiliary side-port.
• This study is the first to demonstrate the AS handpiece's ability to enhance anterior chamber stability in both conventional and one-handed phacoemulsification techniques.