Retrospective Comparison of Intraoperative Parameters, Efficacy and Safety in Cataract Surgery Between Halogen and Light-Emitting Diode (LED) Illuminated Surgical Microscope

Sagol Tangjanyatam Department of Ophthalmology, Hua Hin Hospital, Prachuap Khiri Khan, ThailandCorrespondence: Sagol Tangjanyatam Email golno1@gmail.comPurpose: The objective was to compare the operative time, ultrasound time, efficacy and safety of phacoemulsification with IOL insertion between using halogen and light-emitting diode (LED) illuminated microscope.Patients and Methods: Two hundred and twenty-seven surgical charts of cataract patients who underwent phacoemulsification with IOL insertion between June 2018 and October 2020 were reviewed. There were 113 cases operated on under halogen-illuminated microscope (Carl Zeiss OPMI LUMERA S7®) and 114 cases operated on under light-emitting diode (LED)-illuminated microscope (Leica PROVEO 8®). All cases were operated on by the same surgeon (S.T.). The difference in operative time and ultrasound time between two groups was compared by independent samples t-test. The proportion of cases with 3-months BCVA that was better than 20/30 and the proportion of cases with intraoperative complications from the operation between two groups were compared by Pearson’s Chi-squared test.Results: The mean ultrasound time was 121.29± 53.60 seconds in halogen group and 123.98± 61.53 seconds in LED group. The mean difference was − 2.69± 8.44 seconds which was not statistically significant (95% CI, − 19.35 to 13.97; p=0.573). The mean operative time was 19.83± 4.77 minutes in the halogen group and 17.20± 3.02 minutes in the LED group. The mean difference was 2.63± 0.53 minutes (95% CI, 1.59 to 3.67; p < 0.001). The cases with BCVA better than 20/30 was 93.69% in halogen group and 95.49% in LED group. The proportion of cases with intraoperative complications was 3.53% in halogen group and 2.63% in LED group. The difference of both proportions was not statistically significant (p=0.553 and p=0.692, respectively).Conclusion: This study shows statistically significant operative time reduction with LED microscope. This evidence could be used for making the decision to switch from halogen microscope to LED microscope. Upgrading to LED-illuminated microscope might be beneficial for productivity improvement if there were at least six to seven cases operated on per day. The ultrasound time, efficacy, and safety showed no significant difference.Keywords: operative time, ultrasound time, light source, operative microscope