Study of Efficacy and Safety of Low and High Fluidic Settings in Phacoemulsification Cataract Surgery
Journal Title: International Journal of Research and Review - Year 2018, Vol 5, Issue 4
Abstract
Purpose: To study and compare low and high fluidic settings during phacoemulsification cataract surgery in view of intraoperative efficacy and postoperative outcomes, in moderate grade cataracts. Method: Out of 104 phacoemulsification cataract surgeries, 52 random patients were operated with low and 52 with higher fluidic settings. Preoperative assessment in terms of grading of cataract, baseline central corneal thickness and other prerequisite ocular and systemic investigations were done. Intraoperative efficacy of the two fluidic settings was assessed by comparing quantity of balanced salt solution(BSS) used, and phaco-tip time required. Postoperatively safety was assessed by comparing post-op visual acuity, central corneal thickness and clarity and anterior segment inflammation on post-operative days 1 & 7. Results: Intraoperative efficacy can be convincingly considered to be greater with relatively higher fluidic settings as it requires significantly lesser amount of balanced salt solution and also lesser phaco-tip time to divide and conquer the cataractous nucleus, as compared to low fluidic settings of phacoemulsification. All the surgeries in both the study groups were uneventful and postoperative outcomes in terms of visual acuity, corneal oedema, anterior chamber inflammation and corneal clarity, though initially better with low fluidic settings, were eventually equally matched in both groups by one week postoperatively. Conclusion: Switching from low to relatively high fluidic settings statistically significantly decreases the quantity of fluid used and time of surgery. The occlusion was accomplished more often with high than low fluidic settings. The aspiration of the quadrants was therefore more efficient with high fluidic settings, both fluidic settings are equally safe to use and enhanced pump speed in higher fluidic settings did not cause more tissue damage. In a developing country like ours with limited resources and colossal load of cataracts it can be safely advisable to shift to relatively higher fluidic settings of phacoemulsification which are more efficient and equally safe as low fluidic settings, and require significantly less quantity of prized resources like balanced salt solution and time of the trained phaco-surgeon.
Authors and Affiliations
Dr. Smita Kishor Kadu
Keywords
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