Ting DSJ, et al. - A comparative exploration was performed of the consequence of a high-vacuum setting with a low-vacuum setting on the efficiency of phacoemulsification. An improvement was yielded in the phacoemulsification efficiency via a high-vacuum setting, with the aid of an active fluidics system and torsional phacoemulsification.

Methods

• This study was carried out at Sunderland Eye Infirmary, Sunderland, United Kingdom.
• The plot of this research was a prospective clinical trial.
• The enrollment consisted of consecutive patients who underwent cataract surgery in 2014.
• Cataract surgery was performed by 2 experienced surgeons with the aid of 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, on the basis of the operating list, in order to reduce surgeon bias.
• Cumulative dissipated energy (CDE) and active heminucleus removal time served as the main outcome measures.

Results

• This study recruited one hundred sixty patients (160 eyes) and 158 were included in the analysis.
• Considerably lower CDE per heminucleus was reported 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).
• This paper also determined markedly shorter active heminucleus removal time, 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 variations appeared to be independent of the surgeon, patient age and sex, incision size, and nucleus density.
• Neither group reported intraoperative complications.