Phacoemulsification parameters: Series 20000 Legacy Versus Legacy with AdvanTec software and NeoSoniX handpiece

Abstract

Purpose: To examine the differences in average phaco power and effective phaco time (EPT) and evaluate the clinical results with the standard Series 20000 ® Legacy ® system (Alcon) and the Legacy with AdvanTec ® software and the NeoSoniX ® handpiece (Alcon). Setting: Department of Ophthalmology, University Hospital, Hradec Králové, Czech Republic. Methods: The mean phaco power and EPT in 240 eyes of 240 consecutive patients having cataract surgery by a single surgeon using the standard Legacy 20000 system were retrospectively compared with results in 240 eyes of 240 consecutive patients operated on by the same surgeon using the Legacy with AdvanTec software and the NeoSoniX handpiece. Statistical analysis was performed using the Kruskal-Wallis 1-way analysis of variance. All chi-square (χ 2) values are approximations. Results: The EPT and mean phaco power were less in the AdvanTec–NeoSoniX group than in the standard Legacy 20000 group in all cases. The mean EPT was 56.9 seconds ± 29.5 (SD) in the standard Legacy 20000 group and 4.2 ± 3.8 seconds in the AdvanTec–NeoSoniX group. The mean phaco power was 19.2% ± 6.2% and 5.1% ± 2.5%, respectively. The difference between groups was statistically significant in EPT (age ≥90 years, χ 2 = 4.5, P = .034; age <90 years, χ 2>57, P<.00005) and in mean phaco power (χ 2 = 4.58 and P = .032 and χ 2>44 and P<.00005, respectively). No trace of corneal striae or edema was observed in 92% eyes on the first postoperative day. The best corrected visual acuity was 20/25 or better in 60% of cases. Conclusions: The Legacy system with AdvanTec software and the NeoSoniX handpiece significantly reduced the mean EPT and phaco power. This low-power technology minimizes intraoperative damage to ocular structures and maximizes the level and rapidity of visual rehabilitation.