Comparison of occlusion break responses and vacuum rise times of phacoemulsification systems

Abstract

BackgroundOcclusion break surge during phacoemulsification cataract surgery can lead to potential surgical complications. The purpose of this study was to quantify occlusion break surge and vacuum rise time of current phacoemulsification systems used in cataract surgery.MethodsOcclusion break surge at vacuum pressures between 200 and 600 mmHg was assessed with the Infiniti® Vision System, the WhiteStar Signature® Phacoemulsification System, and the Centurion® Vision System using gravity-fed fluidics. Centurion Active FluidicsTM were also tested at multiple intraoperative pressure target settings. Vacuum rise time was evaluated for Infiniti, WhiteStar Signature, Centurion, and Stellaris® Vision Enhancement systems. Rise time to vacuum limits of 400 and 600 mmHg was assessed at flow rates of 30 and 60 cc/minute. Occlusion break surge was analyzed by 2-way analysis of variance.ResultsThe Centurion system exhibited substantially less occlusion break surge than the other systems tested. Surge area with Centurion Active Fluidics was similar to gravity fluidics at an equivalent bottle height. At all Centurion Active Fluidics intraoperative pressure target settings tested, surge was smaller than with Infiniti and WhiteStar Signature. Infiniti had the fastest vacuum rise time and Stellaris had the slowest. No system tested reached the 600-mmHg vacuum limit.ConclusionsIn this laboratory study, Centurion had the least occlusion break surge and similar vacuum rise times compared with the other systems tested. Reducing occlusion break surge may increase safety of phacoemulsification cataract surgery.

Torsional power study using CENTURION phacoemulsification technology

“…Originally developed in 2013, Centurion monitors intraocular pressure (IOP); when combined with forced infusion, the system will maintain a preset IOP during the procedure (using active fluidics). This is felt to be desirable in preventing occlusion breaks (an influx of fluid into the phaco tip that can cause chamber collapse) . Although some features of this system are new and unique, others, such as the settings for torsional power, vacuum and aspiration, remain similar to other platforms.…”

Experimental anterior chamber maintenance in active versus passive phacoemulsification fluidics systems

“…However, the Centurion has better surge protection than its predecessor, the Infiniti, because of its reduced overall system compliance, which is a significant contributor to anterior chamber stability during such events. 11 The experimental approach described in this report has strengths and weaknesses. The use of a rigid acrylic test chamber to simulate the anterior chamber of a compliant human eye is a limitation because the human eye is slightly compliant.…”

Cataract Surgery with a New Fluidics Control Phacoemulsification System in Nanophthalmic Eyes

“…Therefore, a lower target pressure of 60 mm Hg, which is predetermined by the surgeon, can be maintained to increase patient comfort and decreases the risk of postocclusion surge. A recent laboratory study [10] that compared the surge performance between the Infiniti Vision System (gravity-based fluidics) and the Centurion (Active Fluidics) found that the latter had less surge in the vacuum limit range of 200–600 mm Hg than the former.…”

“…A recent laboratory study reported that this system effectively reduces postocclusion surge [10]. In the current study, we evaluated the safety of performing cataract surgery in nanophthalmic eyes with this system followed by implantation of a single high-power intraocular lens (IOL).…”