Comparative clinical study of Whitestar Signature phacoemulsification system with standard and Ellips FX handpieces

The efficacy and safety profile of cataract procedures performed with a sensor-embedded handpiece and a new hybrid phaco tip

OBJECTIVE

To evaluate the efficacy and safety of the new Intrepid Hybrid tip and Active Sentry handpiece in comparison to the Intrepid Balanced tip and Centurion Ozil handpiece.

METHODS

One hundred sixty-eight eyes were included in the study and randomized into Group 1 (Active Sentry handpiece + Intrepid Hybrid tip, n = 86) and Group 2 (Centurion Ozil handpiece + Intrepid Balanced tip, n = 82). Data were collected from the phaco device, including total U/S time, cumulative dissipated energy (CDE), the total number of active surge mitigation actuations (ASM actuations), torsional amplitude, torsional amplitude on time, estimated fluid of aspirated, and aspiration time. Endothelial cell count (ECC) and central corneal thickness (CCT) were assessed. A correlation analysis was performed between ASM actuations, phaco metrics, and patient characteristics in Group 1.

RESULTS

The CDE, torsional amplitude measured in Group 1 (8.8 ± 3.9, 51.2 ± 13.3, respectively) were significantly lower than those of Group 2 (10.4 ± 4.2, 65.2 ± 9.3, respectively). While no complications were observed in group 1, there were posterior capsule rupture in 2 eyes and iris damage in 1 eye in group 2. The mean ECC and CCT were similar at 1 month. The ASM actuations were more engaged in the eyes with pseudoexfoliation and small pupils.

CONCLUSION

The combination of the new Intrepid Hybrid tip and Active Sentry handpiece enables safer cataract procedures without compromising efficacy due to its surge prevention mechanisms and special tip design. It could be a good option for residents in training.

The effects of trypan blue use on the corneal endothelium during cataract surgery in patients with pseudoexfoliation syndrome (PEX)

PURPOSE

In the present clinical study, it was aimed to investigate the possible effects of Trypan blue (TB) use on the corneal endothelium during cataract surgery in eyes with pseudoexfoliation syndrome (PEX) during a three-month follow-up period using the contralateral eye control design.

METHODS

This prospective, randomised controlled, individual cohort study included 92 eyes of 46 patients with bilateral PEX and cataracts. While 1% TB was applied to one eye of the patients before capsulorhexis (study group), it was not applied to the other eye (control group). Both groups were compared preoperatively and postoperatively in terms of endothelial cell density (ECD), endothelial cell loss (%), pleomorphism, polymegathism and central corneal thickness (CCT) using specular microscopy.

RESULTS

Preoperative corneal ECD was measured as 2362.56 ± 253.27 in the study group, 2380.84 ± 220.54 in the control group, and 2145.58 ± 221.71 in the study group and 2184.97 ± 200.94 cells/mm² in the control group in the postoperative 3rd-month follow-up (p = 0.71 and = 0.37, respectively). In addition, there were no significant differences between the two groups in terms of the percentage of hexagonal cells, coefficient of variation (CV), and CCT both preoperatively and postoperatively 3 months later (p = 0.78, =0.39, =0.95 preoperatively and p = 0.31, =0.26, =0.83 postoperatively, respectively).

CONCLUSION

This study demonstrated that the injection of 1% TB into the anterior chamber for staining the anterior capsule during cataract surgery did not cause significant corneal endothelial changes at postoperative 3^rd months, despite the increased fragility of corneal endothelial cells in patients with PEX.