| Summary: | ObjectiveTo compare the intraoperative efficacies of active-fluidic pressure control phacoemulsification system versus gravity-fluidics on intraoperative efficiency for primary angle-closure glaucoma with cataract, and investigate their effects on postoperative central corneal thickness(CCT), intraocular pressure(IOP), and count of corneal endothelial cells. MethodsA total of 24 patients(48 eyes) with primary angle-closure glaucoma and also accompanied with cataract undergoing surgical treatment in our ophthalmology department from June 2016 to December 2019 were prospectively recruited in this study. With the aid of Alcon Centurion Phacoemulsification Vision System, these patients underwent phacoemulsification with active-fluidics configuration in one eye(active group), and with gravity-fluidics configuration in another eye(gravity group). Their intraoperative parameters, such as cumulative dissipated energy(CDE), total ultrasound(US) time, torsion use time, torsion amplitude, aspiration time, and fluid use, were noted and compared between configurations. Endothelial cell loss, and CCT and IOP changes were evaluated at 1 d, 1 week, and 1 month postoperatively. ResultsThere were no significant differences in the baseline data between the 2 groups. The active group had significantly shorter total US time, torsion use time and aspiration time, and lower amount of fluid use than the gravity group(P<0.05). But no statistical differences were seen in the phacoemulsification energy and torsion amplitude between them. The active-fluidics configuration showed significantly less changes in CCT and IOP at 1 day and 1 week postoperatively than the gravity-fluidics configuration(P<0.01). But such differences were disappeared in 1 month later. There was no notable difference in the loss of endothelial cells at all time points between the 2 groups. ConclusionThe active-fluidics configuration achieve higher surgical efficiency than the gravity-fluidics configuration for angle-closure glaucoma eyes with coexisting cataract, and can guarantee the accuracy of IOP in early stage after surgery.
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