The comparison of handpiece anti-surge system and main body in cataract surgery

Abstract Background: To compare the efficacy of the Centrion handpiece anti-surge system (Active Sentry®) and main body, and evaluate the frequency of the anti-surge system in the Centrion handpiece in cataract surgery according to the grade of nucleosclerosis. Methods: : 600 eyes of 415 patients who underwent cataract surgery was retrospectively enrolled. Intraoperative parameters included phacoemulsification time (seconds), cumulative dissipated energy (CDE), and balanced salt solution (BSS) use (ml). Clinical measurements were made preoperatively and at one day, one month, two, and three months postoperatively, including the best corrected visual acuity (BCVA), and the corneal endothelial cell (CEC) count in the handpiece group (N=300) and main body group (N=300). Within the anti-surge group, the number of anti-surge system activated was collected. Cataract nucleosclerosis grading was done by the Lens Opacities Classification System III. Results: : Anti-surge (times), phacoemulsification time, CDE, and BSS use (ml) significantly increased with increasing nucleosclerosis grades and in patients with zonule weakness, poor mydriasis, and pseudoexfoliation syndrome in the handpiece group, respectively (p < 0.05). Phacoemulsification time, CDE, and BSS use of the handpiece group were significantly lower than those of the main body group (p < 0.05). Phacoemulsification time, CDE, and CEC loss of handpiece group were significantly lower than those of the main body group in nucleosclerosis grade 5 and 6 (p < 0.05). BSS uses of the handpiece group were significantly lower than those of the main body group in all nucleosclerosis grade (p < 0.05). Conclusion: Because of the fast-reacting anti-surge, phacoemulsification time, CDE, and BSS use were saved in the handpiece anti-surge system rather than in the main body. Therefore, the anti-surge system in the Centrion handpiece helps the surgeon perform safer cataract surgery in higher nucleosclerosis grade, zonule weakness, poor mydriasis, and pseudoexfoliation syndrome.