Evaluation of efficacy of new lens nucleus fragmenting forceps in cataract surgery

Faria, Marco Antonio Rey de; Demeda, Vanessa Favero; Cabral, Ana Beatriz Florêncio; Sintra, Ariovaldo Alves Fialho; Pinheiro, Francisco Irochima; Alves, Milton Ruiz

doi:10.37039/1982.8551.20220043

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Revista Brasileira de Oftalmologia

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Original Article • Rev. bras.oftalmol. 81 • 2022 • https://doi.org/10.37039/1982.8551.20220043 copy

Evaluation of efficacy of new lens nucleus fragmenting forceps in cataract surgery

Avaliação da eficácia de uma nova pinça fragmentadora de núcleo do cristalino para cirurgia de catarata

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate the efficacy of low-cost nucleus fragmenting forceps designed to reduce the use of ultrasound during phacoemulsification.

Methods:

A total of 60 pig eyes enucleated 10 hours before were placed in the microwave oven, at maximum power for 10 seconds, to form cataracts with hardness comparable to a grade IV nucleus in the Lens Opacities Classification System III. Cataract extraction was performed using the Centurion® phacoemulsifier (Alcon Laboratories, Geneve, Switzerland) and Leica M620 microscope. All eyes were submitted to the pre-chop technique dividing the nucleus into four parts. After the pre-chop, the quadrants in 30 eyes were phacoemulsified with the torsional mode and were fragmented in the remaining 30 eyes after the pre-chop was with the fragmentation forceps before torsional mode phacoemulsification. The device was calibrated for all eyes by applying the following parameters: 40% linear torsional phacoemulsification; intraocular pressure of 65 mmHg; the linear vacuum of 600 mmHg; aspiration flow of 40 ccs/minute. After each procedure, the following was recorded: cumulative dissipated energy; equivalent average torsional amplitude; equivalent average ultrasonic power; estimated aspirated fluid; ultrasound total time; and total aspiration time. Statistical analysis was performed using the Kruskal-Wallis test and the IBM Statistical Package for Social Sciences. The p-value <0.05 was considered statistically significant.

Results:

There was a statistically significant reduction favoring the use of the nucleus fragmenting forceps in all parameters, except for the average torsional amplitude.

Conclusion:

The use of the nucleus fragmenting forceps contributed to improving the efficacy of torsional phacoemulsification in enucleated pig eyes.

Keywords:
Cataract; Phacoemulsification/methods; Rehabilitation

Variables		n	Average	Mean difference (MD)	Standard error (SE)	95% confidence interval (MD)	p-value
Cumulative dissipated energy
	No forceps	30	4.80	2.50	0.71	1.09-3.91	0.004^* * Statistically significant at 5%.
	With forceps	30	2.30
Equivalent average torsional amplitude
	No forceps	30	0.27	0.07	0.02	0.03-0.12	0.134
	With forceps	30	0.20
Equivalent average ultrasonic power
	No forceps	30	0.11	0.01	0.01	-0.01-0.04	0.014^* * Statistically significant at 5%.
	With forceps	30	0.09
Estimated aspirated fluid
	No forceps	30	27.40	11.13	3.16	4.81-17.45	<0.0001^* * Statistically significant at 5%.
	With forceps	30	16.27
Ultrasound total time (US)
	No forceps	30	2,627.37	1,206.73	299.08	608.06-1,805.40	<0.0001^* * Statistically significant at 5%.
	With forceps	30	1,420.63
Total aspiration time
	No forceps	30	4,156.00	1,134.00	519.55	94.00-2,174.00	0.001^* * Statistically significant at 5%.
	With forceps	30	3,022.00

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[1] Corresponding author: Marco Antônio Rey de Faria, Avenida Afonso Pena, 1.212 – Tirol Zip code: 59020-265 – Natal, RN, Brazil. E-mail: marco.rey@uol.com.br