Assessing clinical efficacy of new method for adaptive infusion control in phacoemulsification

Aznabaev BM1,2, Mukhamadeev TR1,2, Ismagilov TN1,2, Dibaev TI1,2
About authors

1 Bashkir State Medical University, Ufa, Russia

2 ZAO "Optimedservis", Ufa, Russia

Correspondence should be addressed: Timur N. Ismagilov
Lenina, 3, Ufa, 450008, Russia; ur.kb@rumit-voligamsi

About paper

Author contribution: Aznabaev BM — developing the concept, approving final version of the article; Mukhamadeev TR — developing the concept, manuscript editing; Ismagilov TN — research procedure, manuscript writing and editing; Dibaev TI — manuscript writing and editing.

Compliance with ethical standards: the study was approved by the Ethics Committee of the Bashkir State Medical University (protocol № 10 dated 15 December 2021). All patients submitted the informed consent to surgical treatment and personal data processing.

Received: 2024-01-19 Accepted: 2024-02-10 Published online: 2024-02-28

Reduction of the adverse effects of intraoperative intraocular pressure fluctuation referred to as post-occlusion surge on the intraocular structures is an important task for ensuring phacoemulsification safety. In this regard, the method to control infusion during phacoemulsification based on controlling the infusion and aspiration flow rates in combination with monitoring of vacuum parameters was developed. The study was aimed to provide comparative assessment of clinical and functional characteristics of the eye in patients after phacoemulsification using the new and already existing adaptive infusion control methods. A total of 38 patients aged 66.4 ± 7.8 years (15 males and 23 females) in the index group (Optimed Profi system with the use of new method) and 35 patients aged 68.7 ± 7.5 years (16 males and 19 females) in the control group (Centurion Vision System with Active Fluidics) underwent surgery due to cataract. The patients underwent comprehensive eye examination before surgery and on days 1, 7, 30, months 3, 6 after surgery. The smaller loss of corneal endothelial cells on months 3 and 6 after surgery was observed in patients of the index group with grade III and IV cataract (p < 0.05). Comparison of macular microcirculation parameters revealed the reduced FAZ area by month 6 of postoperative follow-up in the index group, along with the increased total vascular density of the deep vasculature (p < 0.001). A significant decrease in the total density of the superficial and deep vascular plexuses by month 6 of postoperative follow-up was observed in the control group (p < 0.05). The use of new adaptive infusion control method contributes to effective phacoemulsification of cataracts of varying density with the lower percentage of the corneal endothelial cells lost in the late postoperative period.

Keywords: optical coherence tomography, intraocular pressure, phacoemulsification, postocclusion surge, corneal endothelium, ocular perfusion pressure