Comparative clinical study of Whitestar Signature phacoemulsification system with standard and Ellips FX handpieces

Purpose: To compare the intraoperative parameters and postoperative outcomes using two different phaco handpieces with different energy delivery systems of the same phacoemulsification machine. Methods: One hundred and sixty eyes of 160 cataract patients were randomly assigned to 2.40 mm phacoemulsification using the AMO WhiteStar Signature® phaco system with the standard phaco handpiece (Group 1) or the Ellips FX phaco handpiece (Group 2). According to the lens opacities classification system III, each group was divided into four subgroups of 20 patients each. U/S total time (UST), total phaco time (TPT), mean effective phaco time, cumulative dissipated energy (CDE) and balanced salt solution (BSS) consumption were studied. Visual acuity, corneal endothelium cell count and corneal pachymetry were evaluated before surgery and 1, 7 and 30 days after surgery. Results: No statistically significant difference in terms of visual acuity was observed between the two groups. The postoperative endothelial cell loss and corneal pachymetry were similar between the two groups. In higher density cataracts, Ellips FX showed the lower CDE and the lowest UST. TPT and BSS consumption were significantly lower in the Ellips FX handpiece group. Conclusions: The two phaco handpieces appeared to be safe. AMO Ellips FX handpiece showed better performances and may be safer in lens removal, especially in hard cataract patients.