Phacoemulsification at High IOP and Physiologic IOP: Impact on Anterior and Posterior Segment Physiology

To investigate the anterior and posterior physiological changes when performing phacoemulsification at high IOP vs low, more physiologic IOP using Centurion® Vision System with Active Sentry® handpiece

Prospective, single-surgeon, randomized, paired-eye study; patients undergoing sequential, uncomplicated bilateral phacoemulsification using Active Sentry handpiece® with intraocular IOP ≤ 28mmHg (low IOP) in one eye and with IOP ≥ 60mmHg (high IOP) in the other eye

Operating at lower, more physiological IOP using Active Sentry® handpiece during cataract surgery will use less BSS fluid usage. (Lower IOP settings are also expected to result in less subclinical changes).

Inclusion criteria

• No prior ocular surgery including corneal refractive surgery
• Bilateral visually significant cataract, similar in density (LOCS III grade 2+), undergoing uncomplicated cataract surgery
• Equal dilated pupil size ≥6mm, no use of pupil expansion devices
• Unremarkable systemic health but inclusive of controlled type II diabetes and hypertension with normal OCT angiography at baseline
• A1C ≤ 8% on single monotherapy or lifestyle adjustments
• To maintain high sensitivity/specificity, patients to fall under OCT normative database:
• Axial length 22-26mm
• Refractive error between -5.00D to +5.00D
• Cylinder ≤ 3.00D
• Normal K values <47.00D
• Axial eye length cannot vary by more than 0.4 mm in an individual patient
• Normal CCT range 540µm ± 50

Exclusion criteria

• H/o corneal disease or dystrophies
• Media opacification for reasons other than cataract
• Compromised zonular integrity or stability
• Retinal and retinal vascular pathologies, age-related macular degeneration
• Glaucoma
• Patients with uncontrolled systematic diseases; including hypertension, diabetes, systemic cardiovascular diseases and hematological diseases