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Valbon B; Canedo A; Pimentel L; Ramos Isaac, Louzada R. Ambrosio Jr R

Correlation between Preoperative cataract grading by Scheimpflug imaging and phaco time and power US in phacoemulsification. Bruno Valbon; Ana Canedo ; Leonardo Pimentel; Isaac Ramos; Ricardo Louzada; Renato Ambrósio Jr.

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Valbon B; Canedo A; Pimentel L; Ramos Isaac, Louzada R. Ambrosio Jr R

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  1. CorrelationbetweenPreoperativecataractgradingby Scheimpflug imagingandphaco time andpower US in phacoemulsification. Bruno Valbon; Ana Canedo; Leonardo Pimentel; Isaac Ramos; Ricardo Louzada; Renato Ambrósio Jr. * Dr. Ambrosio is a consultant to Oculus and in the speaker bureau for Reichert, Alcon and Allergan

  2. Purpose : To analyze the correlation between patient nuclear score (PNS) by Scheimplufg imaging and phaco time and power US in patients who had uneventful clear cornea phacoemulsification Valbon B; Canedo A; Pimentel L; Ramos Isaac, Louzada R. Ambrosio Jr R

  3. INTRODUCTION • The current standard for gradingcataracts is theLensOpacificationClassification System III (LOCS III). • This system is, however, potentiallysubjective and theresults are open to interpretation. Anobjective and reproduciblemethod of cataractevaluation is not yetavailable. • Furthermore, there is no universal meansbywhich to correlatetheobjectivecataractevaluationwiththeamount of energyneeded to remove a cataractduring phacoemulsification. • The efficiency of ultrasound (US) energy use in phacoemulsification systems is critical. • Lowerlevels of US powercanlimitendothelialcelldamage; therefore, it makessense to planphacosurgerywiththelowestlevels of US powerneededbasedoncataractdensity. • Is common for surgeons to alterphacosettingsintraoperativelyaccording to theden- sity of thecataract. • It wouldbe more efficient to set phacovariablespreoperativelybasedonobjective and reproduciblecataractdensityresults. Valbon B; Canedo A; Pimentel L; Ramos Isaac, Louzada R. Ambrosio Jr R

  4. METHODS • Patients scheduled to have cataract surgery by the same surgeon (RA) had similar preoperative evaluations, including Pentacam Scheimpflug assessment using the PNS. • Patients were excluded if preoperative examinations indicated a need for complex cataract surgery that could lead to complications. • 22 eyes from 22 patients who had uneventful clear cornea phacoemulsification and foldable IOL implantation were included. • Phacotime and power US were performed after surgery each patient. • The Test Kolmorogov-Smirnov was used to evaluate normal distribuition. • The correlations were evaluated with Pearson rank correlation. A P value lower than 0,05 was considered statistically significant. • PNS x Phaco Time and PNS x US power were correlations realized. Valbon B; Canedo A; Pimentel L; Ramos Isaac, Louzada R. Ambrosio Jr R

  5. METHODS (PNS – pentacam nucleus staging) Valbon B; Canedo A; Pimentel L; Ramos Isaac, Louzada R. Ambrosio Jr R

  6. METHODS (PNS – pentacam nucleus staging) X LOCS III PNS 1 PNS 3 Valbon B; Canedo A; Pimentel L; Ramos Isaac, Louzada R. Ambrosio Jr R

  7. 22 eyes of 22 patients were studied. • Correlation between PNS x Phaco Time was p < 0,0050 and RP (Rank - Pearson) 0,5757 (Graphic 1). • Correlationbetween PNS x Power US wasp < 0,0029 e RP( Rank - Pearson) de 0,6034 (Graphic 2). Results : Valbon B; Canedo A; Pimentel L; Ramos Isaac, Louzada R. Ambrosio Jr R

  8. DISCUSSION • The ability to objectively and reproducibly assess pre-operative characteristics of the nuclear component of a cataract to determine its grade would have value in preoperative surgical planning. • The most widely used cataract grading system, the LOCS III, is open to interpretation because of its subjective nature; thus, surgeons have no analytical tool to link cataract grade and surgical settings. • In this study, a Scheimplug imaging system was used to determine objective cataract grades, with the phaco parameters adjusted preoperatively and to realize correlations between phaco time, power US and PNS. • This present study found a statistically significant between PNS, phaco time and power US. • In conclusion, customizing phaco parameters based on an objective cataract grading may be a means to improve phaco efficiency. Valbon B; Canedo A; Pimentel L; Ramos Isaac, Louzada R. Ambrosio Jr R

  9. CorrelationbetweenPreoperativecataractgradingby Scheimpflug imagingandphaco time andpower US in phacoemulsification valbonbruno@ig.com.br Bruno Valbon; Ana Canedo; Leonardo Pimentel; Isaac Ramos; Ricardo Louzada; Renato Ambrósio Jr. Thankyou !! Valbon B; Canedo A; Pimentel L; Ramos Isaac, Louzada R. Ambrosio Jr R

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