NeoSoniX ultrasound versus ultrasound alone for phacoemulsification: Randomized clinical trial☆

Purpose: To evaluate the difference in consumption of ultrasound (US) energy required with NeoSoniX® (Alcon) in conjunction with US (NeoSonix US) versus US alone.

Setting: Iladevi Cataract & IOL Research Center, Ahmedabad, India.

Methods: This prospective randomized study comprised 120 consecutive eyes having phacoemulsification with the Alcon Legacy® 20000® series at Iladevi Cataract & IOL Research Centre. Two groups of 60 eyes each were formed based on cataract grade according to the Emery classification: grade 2 and 3 nuclear sclerosis (Group A) and grade 4 and 5 nuclear sclerosis (Group B). In each group, 30 eyes had phacoemulsification using NeoSoniX US and 30 eyes, using US alone. The main parameters were intraoperative US time and mean US power. Effective phaco time (EPT) was calculated by multiplying the US time and mean US power and dividing the product by 100. The unpaired Student t test was used to evaluate the differences between NeoSoniX US and US alone. The corresponding 95% confidence intervals were calculated.

Results: In Group A, the mean US time was 106 seconds with NeoSoniX US and 144.30 seconds with US alone (P = .002), the mean US power was 13.50% and 15.83%, respectively (P = .059), and the mean EPT was 15.17 seconds and 22.94 seconds, respectively (P = .006). In Group B, the mean US time was 193.67 seconds with NeoSoniX US and 255.17 seconds with US alone (P = .000), the mean US power was 18.31% and 22.76%, respectively (P = .000), and the mean EPT was 35.67 seconds and 59.15 seconds, respectively (P = .000). The EPT was 33.5% and 39.6% less with NeoSoniX US than with US alone in Group A and Group B, respectively.

Conclusions: Ultrasound energy consumption with NeoSoniX was significantly less than with US alone, indicating the value of NeoSoniX in emulsifying cataracts of optimum density and dense hard cataracts. Combining NeoSoniX and US significantly reduced the consumption of US energy.