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

Background/aims To compare the efficacy of the Centrion handpiece anti-surge system (Active Sentry®) and main body 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. Results Anti-surge (times), phacoemulsification time, CDE, and BSS use significantly increased with increasing nucleosclerosis grades and in zonule weakness, poor mydriasis, and pseudoexfoliation syndrome in handpiece group, respectively (p < 0.05). Phacoemulsification time, CDE, and BSS use of handpiece group were significantly lower than those of main body group (p < 0.05). Phacoemulsification time, CDE, and CEC loss of handpiece group were significantly lower than those of main body group in nucleosclerosis grade 5 and 6 (p < 0.05). BSS uses of handpiece group were significantly lower than those of main body group in all nucleosclerosis grade (p < 0.05). Conclusion Because of the fast-reacting anti-surge, Intraoperative parameters were saved in handpiece anti-surge system rather than in 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. Synopsis 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. WHAT IS ALREADY KNOWN ON THIS TOPIC Active Sentry handpiece was reported to be as safe and efficacious as the Ozil handpiece, with the benefit of operating at lower intraocular pressure levels WHAT THIS STUDY ADDS 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. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY With anti-surge system in the Centrion handpiece, phacoemulsification can be performed effectively and safely in patients with complicated cataract.