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A novel method to compare phacoemulsification parameters in vivo: two halves of one nucleus

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Abstract

Background

Comparison of different phacoemulsification parameters remains a frequently debated and methodologically challenging area. The focus of this study was twofold: (1) To suggest an accurate and simple in vivo model for comparison of phaco parameters with the use of femtosecond laser technology. (2) To compare parameters of intelligent phaco (IP) torsional and combination ultrasound modes using the proposed model.

Methods

Forty-three eyes underwent femtosecond laser-assisted cataract surgery (FLACS) with the precise division of each nucleus into two equal hemispheres. This approach was applied to compare two variants of phacoemulsification settings. In each case, one hemisphere was removed with the torsional ultrasound (US) with IP, while another hemisphere was evacuated with combination US. Aspiration time, cumulative dissipated energy (CDE), and fluid consumption were measured in all cases.

Results

Our approach allows for direct comparison of different phacoemulsification parameters on each half of the same nucleus under identical surgical conditions. When comparison between torsional US with IP and combination US was made, without regard to nucleus density, no statistically significant difference in CDE, aspiration time, and fluid consumption was found. However, in soft cataracts, CDE was lower with the use of torsional US with IP, while aspiration time and fluid consumption demonstrated no proven differences. In hard cataracts, CDE and aspiration time were significantly lower with the use of the combination US mode.

Conclusions

The suggested approach of testing different types of phaco settings on equal halves of the same nucleus can be easily applied for quantitative comparisons under identical surgical conditions. The data obtained suggest that IP technology is preferable when compared to a combination US mode for soft lenses while the combined US is more suitable for hard nuclei.

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Acknowledgements

We are grateful to Fedor V. Konstantinov and Natalia V. Bondarenko for supporting this work. Valuable comments and suggestions of two anonymous referees significantly improved the paper.

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Authors and Affiliations

  1. S. Fyodorov Eye Microsurgery Clinic, Saint Petersburg Branch, Yaroslava Gasheka str. 21, Saint Petersburg, 192283, Russia

    Elena Tomilova & Sergey Shukhaev

Authors
  1. Elena Tomilova
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  2. Sergey Shukhaev
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Corresponding author

Correspondence to Elena Tomilova.

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Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the S. Fyodorov Eye Microsurgery Federal State Institution and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Tomilova, E., Shukhaev, S. A novel method to compare phacoemulsification parameters in vivo: two halves of one nucleus. Graefes Arch Clin Exp Ophthalmol 254, 1579–1584 (2016). https://doi.org/10.1007/s00417-016-3376-0

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  • DOI: https://doi.org/10.1007/s00417-016-3376-0

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