Active fluidics allows high vacuum and reduces phaco energy, lens removal time
BOSTON — A phacoemulsification machine with active fluidics enabled surgeons to use high vacuum while reducing cumulative dissipated energy and lens removal time, a clinician told colleagues here.
At the American Society of Cataract and Refractive Surgery annual meeting, David Allen, FRCOphth, discussed a study of the Centurion Vision System (Alcon).
“The problem with a traditional system is that if you’re going to use a high vacuum, you need to have a high bottle height,” Allen said. “Not many surgeons have done the mathematical calculation to work out that a bottle height of, say, 110 cm is equivalent to an 81 mm Hg intraocular pressure.”
The study included 178 patients who underwent torsional phacoemulsification. A target IOP of 40 mm Hg, equivalent to a bottle height of 57 cm, was programmed into the machine.
Surgeons removed half of each lens nucleus with low vacuum (up to 350 mm Hg) and the other half with high vacuum (up to 600 mm Hg).
Results showed that mean cumulative dissipated energy was 3.81 in the low vacuum group and 2.81 in the high vacuum group. The difference was statistically significant (P < .001).
Mean fluid use was 10.46 in the low vacuum group and 9.51 in the high vacuum group (P < .036).
Mean lens removal time was 34 seconds in the low vacuum group and 28 seconds in the high vacuum group (P < .001).
There were no safety issues, and the anterior chamber was stable, Allen said.
As small incisions gain a foothold, the Centurion system will allow surgeons to use small phacoemulsification needles safely and effectively with high vacuum, Allen said.
Disclosure: Allen is a consultant for Alcon.