Darren Shu Jeng Ting1, Jon Rees1, Jia Yu Ng1, David Allen1, David H W Steel2. 1. From the Sunderland Eye Infirmary (Ting, Ng, Allen, Steel), the School of Psychology (Rees), University of Sunderland, Sunderland, and the Institute of Genetic Medicine (Steel), Newcastle University, Newcastle upon Tyne, United Kingdom. 2. From the Sunderland Eye Infirmary (Ting, Ng, Allen, Steel), the School of Psychology (Rees), University of Sunderland, Sunderland, and the Institute of Genetic Medicine (Steel), Newcastle University, Newcastle upon Tyne, United Kingdom. Electronic address: dhwsteel@hotmail.com.
Abstract
PURPOSE: To evaluate the effect of a high-vacuum setting versus a low-vacuum setting on the efficiency of phacoemulsification. SETTING: Sunderland Eye Infirmary, Sunderland, United Kingdom. DESIGN: Prospective clinical trial. METHODS: Consecutive patients having cataract surgery in 2014 were recruited. Cataract surgery was performed by 2 experienced surgeons using a phacoemulsification machine with monitored forced infusion. The cataractous lens was split into 2 heminuclei using the stop-and-chop technique; in 1 heminucleus, phacoemulsification and aspiration used a high-vacuum setting (600 mm Hg; treatment group) and in the other heminucleus, a low-vacuum setting (350 mm Hg; control group). The high and low settings were alternated by case per the operating list to reduce surgeon bias. The main outcome measures were cumulative dissipated energy (CDE) and active heminucleus removal time. RESULTS: One hundred sixty patients (160 eyes) were enrolled in the study, and 158 were included in the analysis. The CDE per heminucleus was significantly lower with the high-vacuum setting than with the low-vacuum setting (mean 2.81 percent-seconds; 95% confidence interval (CI), 2.44-3.21 versus 3.81 percent-seconds; 95% CI, 3.38-4.20; P < .001). The active heminucleus removal time was significantly shorter in the high-vacuum group than the low-vacuum group (mean 27.77 seconds; 95% CI, 25.26-30.19 versus 33.59 seconds; 95% CI, 31.07-35.92; P < .001). The observed differences were independent of the surgeon, patient age and sex, incision size, and nucleus density. No intraoperative complications were observed in either group. CONCLUSION: A high-vacuum setting improved phacoemulsification efficiency using an active fluidics system and torsional phacoemulsification.
PURPOSE: To evaluate the effect of a high-vacuum setting versus a low-vacuum setting on the efficiency of phacoemulsification. SETTING: Sunderland Eye Infirmary, Sunderland, United Kingdom. DESIGN: Prospective clinical trial. METHODS: Consecutive patients having cataract surgery in 2014 were recruited. Cataract surgery was performed by 2 experienced surgeons using a phacoemulsification machine with monitored forced infusion. The cataractous lens was split into 2 heminuclei using the stop-and-chop technique; in 1 heminucleus, phacoemulsification and aspiration used a high-vacuum setting (600 mm Hg; treatment group) and in the other heminucleus, a low-vacuum setting (350 mm Hg; control group). The high and low settings were alternated by case per the operating list to reduce surgeon bias. The main outcome measures were cumulative dissipated energy (CDE) and active heminucleus removal time. RESULTS: One hundred sixty patients (160 eyes) were enrolled in the study, and 158 were included in the analysis. The CDE per heminucleus was significantly lower with the high-vacuum setting than with the low-vacuum setting (mean 2.81 percent-seconds; 95% confidence interval (CI), 2.44-3.21 versus 3.81 percent-seconds; 95% CI, 3.38-4.20; P < .001). The active heminucleus removal time was significantly shorter in the high-vacuum group than the low-vacuum group (mean 27.77 seconds; 95% CI, 25.26-30.19 versus 33.59 seconds; 95% CI, 31.07-35.92; P < .001). The observed differences were independent of the surgeon, patient age and sex, incision size, and nucleus density. No intraoperative complications were observed in either group. CONCLUSION: A high-vacuum setting improved phacoemulsification efficiency using an active fluidics system and torsional phacoemulsification.
Authors: Darren S J Ting; Daniel Chua; Khin Oo May; Mya Aung; Ashish Kumar; Mohamed Farook; Hla M Htoon; Chelvin C A Sng; Marcus Ang Journal: Ther Adv Ophthalmol Date: 2020-12-08