Effect of increasing flow when grooving during phacoemulsification

Bird, Brian A; Thomson, Rhett S.; Stutz, Lance A.; Heczko, Joshua; Bernhisel, Ashlie; Barlow, William R.; Zaugg, Brian; Pettey, Jeff H.; Olson, Randall J.

doi:10.1016/j.jcrs.2018.01.034

Cited by 6 publications

(9 citation statements)

References 23 publications

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“…This study is the second in a series seeking to identify optimal settings during the grooving step. The first study determined that for dense nuclei, the flow rate is optimized at 40 mL/min 27. The data in this study indicate optimal longitudinal power settings at 70% during the grooving stage of cataract surgery when compared to 40% and 100% longitudinal power, and somewhat surprisingly that higher power settings have no additional benefit in this setting.…”

Section: Discussionmentioning

confidence: 77%

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<p>The effect of increasing power when grooving using phacoemulsification</p>

Thomson

Bird

Stutz

et al. 2019

OPTH

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Purpose To determine optimal power settings on the Centurion Vision System during the grooving step in cataract surgery. Methods Intact porcine lenses hardened by formalin and placed in a chamber designed to simulate the anterior chamber of the eye were used to test longitudinal power at 40%, 70%, and 100% and torsional power at 0%. Flow rate was set at 40 mL/min. Vacuum was set at 400 mmHg, intraocular pressure was set at 50 mmHg, and a balanced phacoemulsification tip with a 20 degree tip and a 30 degree bevel was used. Efficiency (time to groove the lens in half) was determined. Results Increasing longitudinal power from 40% to 70% increased efficiency by 28% ( P <0.05), and by 32% ( P <0.05) when increasing longitudinal power from 40% to 100%. There was no statistically significant increase in efficiency from 70% to 100%. Conclusion For the tested variables, a longitudinal power of 70% was determined to be most efficient during the grooving step of cataract surgery for equivalent 3–4+ nuclei. Further increases in power demonstrated no statistically significant improvement in efficiency.

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Section: Discussionmentioning

confidence: 77%

“…This study is the second in a series that will determine the optimal settings for nucleus grooving. The first study found the optimal aspiration flow rate was 40 mL/min 27. This study now examines optimal longitudinal power using a porcine lens model developed in our laboratory.…”

Section: Introductionmentioning

confidence: 99%

<p>The effect of increasing power when grooving using phacoemulsification</p>

Thomson

Bird

Stutz

et al. 2019

OPTH

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“…Other settings such as the flow rate and vacuum are also factors that affect the efficiency of PKE significantly. A flow rate of 40 mL/min was once determined to be more efficient than 20 mL/min and 60 mL/min [ 25 ]. Additionally, a high-vacuum setting of 600 mmHg was proved to be more efficient than 350 mmHg [ 12 ].…”

Section: Two Different Fluidics Systems Of Pkementioning

confidence: 99%

Application of the Active-Fluidics System in Phacoemulsification: A Review

Luo

et al. 2023

JCM

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The fluidics system is an indispensable and primary component of phacoemulsification. Both the gravity-fluidics system and active-fluidics system are commonly used in practice. The irrigation pressure of the gravity-fluidics system is determined by the bottle height, which is relatively constant, while the active-fluidics system is paired with a cassette that contains pressure sensors to monitor intraocular pressure changes. The active-fluidics system allows surgeons to preset a target intraocular pressure value, and it replenishes the fluids proactively; thus, the intraocular pressure is consistently maintained near the target value. Under such circumstances, stable intraocular pressure and anterior chamber volume values could be acquired. Research on surgical safety, efficiency and results have reported several strengths of the active-fluidics system. It is also advantageous in some complicated cataract surgeries. However, the system is not widely used at present, mainly due to its low penetration rate and high equipment cost. Some of its updates such as the new Active Sentry handpiece showed potential superiority in laboratory studies recently, but there is still further research to be conducted. This article gives an overview of the mechanism and performance of the active-fluidics system, and it is expected to provide clues for future research.

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“…Optimal phaco settings have been evaluated on many other commonly used machines. 10–36 Due to the unique size and portability of the CataRhex platform, evaluating surgical settings on this system is an important area of research. Minimizing the power and duration of phaco engaged intraoperatively improves outcomes and minimizes complications.…”

Section: Introductionmentioning

confidence: 99%

Optimization of Phacoemulsification Tip Gauge on the Oertli CataRhex3 in an in vitro Setting

Peterson

Christensen

Cooper

et al. 2022

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Purpose To evaluate the effect of each of the tip sizes available for the Oertli CataRhex3 ® phacoemulsification machine on efficiency. Methods Porcine lenses were fixed in formalin for 2 hours, then cut into 3.0 mm cubes. We studied three Oertli tips, all of which had a 30-degree bevel: easyTip 2.2 mm (20G), easyTip 2.8 mm (19G), and CO-MICS (21G). For the 19G and 20G tips, vacuum was set at 600 mmHg, irrigation rate at 50 mL/min, continuous power 70%, and bottle height 85 cm. For the 21G tip, vacuum was set at 450 mmHg; irrigation and power settings were identical to those used for the easyTip tips. We measured time to removal and chatter events to determine efficiency. Results Results from 20 trials for each tip showed that the larger the gauge size, the more quickly lens fragments were removed. Chatter events demonstrated an increasing trend with smaller tip gauge. The 19G tip used an average time to fragment removal of 2.8 seconds; the 20G, 3.2 seconds; and the 21G, 4.6 seconds. Increasing tip diameter from 21G to 20G decreased emulsification time by 33% (P = 0.02). Increasing the diameter from 21G to 19G further decreased time to emulsification by 42% (P = 0.003). The 21G tip had a mean 1.4 events/cube; 20G, 0.35 events; and 19G, 0.1 events. Differences in mean chatter events for each tip were each statistically significant. Conclusion These data suggest that when evaluated by chatter events and emulsification time, the 2.8 mm (19G) easyTip proves to have greatest efficiency.

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Effect of increasing flow when grooving during phacoemulsification

Cited by 6 publications

References 23 publications

<p>The effect of increasing power when grooving using phacoemulsification</p>

<p>The effect of increasing power when grooving using phacoemulsification</p>

Application of the Active-Fluidics System in Phacoemulsification: A Review

Optimization of Phacoemulsification Tip Gauge on the Oertli CataRhex3 in an in vitro Setting

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