Fluid-based phaco outperforms ultrasound

Performing cataract surgery using a fluid-based method of phacoemulsification results in less corneal endothelial cell loss compared with conventional ultrasound phacoemulsification, according to a report published in the January issue of Cornea.

Jêrôme Richard MD and colleagues from France, compared in vivo corneal endothelial cell loss from phacoemulsification performed with the Alcon Infiniti vision system using either AquaLase or conventional ultrasound. The study included 42 eyes of 42 patients who were randomly assigned to undergo surgery with one of the two modalities. In each case, surgeons used the divide-and-conquer technique through a 3.2 mm clear corneal incision and capsular bag intraocular lens (IOL) implantation.

Preoperatively, both groups had similar nuclear opalescence, averaging 4.5 on the LOCS III scale and only eyes with cataracts of nuclear opalescence graded up to 4.9 were included.

At one-week follow-up, endothelial cell loss averaged 498 cells/mm² (20.6%) in the ultrasound group and 302 cells/mm² (22.9%) in the fluid-based group. At one-month, endothelial cell loss averaged 589 cells/mm² (24.3%) and 254 cells/mm² (11.2%) in the ultrasound and fluid-based groups, respectively and at three-months follow-up, cell loss averaged 555 cells/mm² (22.9%) and 247 cells/mm² (10.9%) in the ultrasound and fluid-based groups, respectively.

The researchers concluded that fluid-based phacoemulsification results in significantly less endothelial cell loss than traditional ultrasound techniques.