Comparison of Post-Operative Outcomes between IOP-20 and IOP-50 in Phacoemulsification with Active Fluidics System: Randomized Single Blinded Trial

Chandrashekhar M Wavikar,1 Mamta N Tanna,1 Gargi C Wavikar,2 Chandrashekhar B Kale,1 Maninder Singh Setia3 1Department of Ophthalmology, Wavikars Eye Hospital and Wavikar Eye Institute, Thane, Maharashtra, India; 2Department of Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India; 3Department of Epidemiology, Wavikars Eye Hospital and Wavikar Eye Institute, Thane, Maharashtra, IndiaCorrespondence: Maninder Singh Setia, Wavikars Eye Hospital and Wavikar Eye Institute, 4 th and 5 th Floor, Amber Arcade, Near Lodha Paradise, Bhivandi Bypass Road, Thane, MH, India, 400601, Email [email protected]: To compare the central corneal thickness, mitigation events, post-operative vision, and complications in patients who underwent cataract surgery using the CENTURION ® Vision System with the ACTIVE SENTRY ® (Alcon Industries, Inc.) system and were assigned to one of two groups: intraocular pressure (IOP) group 20 or 50.Setting: Wavikar Eye Institute, Thane, India.Design: A prospective comparative two arm, randomized, single blinded, interventional study.Methods: A total of 107 eyes were randomized to either the IOP-20 (n=55) or IOP-50 (n=52) group. All patients underwent phacoemulsification with an active fluidics system performed by a single surgeon; intraocular pressure (IOP) was set at either 20 or 50 mmHg.Results: The mean [SD] baseline CCT in the IOP-20 group was 511.9 [35.7] μm and it was 521.1 [34.8] μm in the IOP 50 group (p=0.18). It had changed to 530.6 [39.8] μm in the IOP-20 group and 539.5 [39.2] μm in the IOP 50 (p=0.24). The mean [SD] ECD at the end of day 90 was 2423.0 [204.6] cells/mm2 in the IOP-20 group and 2476.1 [236.0] cells/mm2 in the IOP-50 group (p=0.22). Approximately 22% of the eyes in the IOP-20 group and 77% of the eyes in the IOP-50 group required active surge mitigation; this difference was statistically significant (p< 0.001).Conclusion: We found that the phacoemulsification with an active fluidics system handpiece at 20 mmHg provided a safe and stable environment for cataract surgery.Keywords: active fluidics system, IOP-20, IOP-50, safety, effectiveness