Anterior Chamber Stability Of A Novel Phacoemulsification Machine Via Intraoperative Oct And Surgical Microscope Videos
Published 2026 - 44th Congress of the ESCRS
Reference: FP29.07 | Type: Free paper | DOI: 10.82333/3p9h-8d40
Authors: Dr Hisaharu Suzuki* 1 , Ms Marcia Ong 2 , Mr Satish Yalamanchili 2 , Ms Samantha Do 2 , Ms Mai Kurose 3 , Ms Ashleigh Cooper 2 , Dr Nanhong Lou 2 , Ms Sarah Makari 2
1Zengyo Suzuki Eye Clinic,Fujisawa,Japan, 2Alcon Research LLC, Fort Worth, TX, USA,Fort Worth,United States, 3Alcon Japan,TOKYO,Japan
Purpose
Previous work evaluated anterior chamber (AC) stability of UNITY VCS (UVCS) and CENTURION ACTIVE SENTRY (CAS) during simulated occlusion break via the slit side view (SSV) slit lamp method. This study aims to quantify AC stability in an operative room (OR) setting using intraoperative OCT (iOCT) and iris movement via surgical microscope.
Setting
Experimental bench-top, surgical simulation and porcine eye study; Alcon Research LLC, Fort Worth, Texas, USA.
Methods
12 porcine eyes were tested at intraocular pressure (IOP) 20, 30, 40 mmHg, vacuum limits 550, 600, 650 mmHg, and aspiration rate 40 cc/min. Each eye was pinned on a fixture and a 2.4mm incision was created under a surgical microscope. The phaco handpiece was secured to minimize leakage and movement throughout the procedure. UVCS and CAS were tested in each eye and choice of first machine was alternated. Continuous irrigation was used to stabilize IOP before an occlusion break was simulated by pinching the aspiration line with pliers for 3 seconds then released. The AC depth (ACD) and pupil diameter change ratio using iOCT and the pupil area change ratio using a surgical microscope were recorded.
Results
The percent change in ACD was statistically significantly less with UVCS compared to CAS across all tested settings (p<0.0001). Similarly, pupil area and pupil diameter changes during surge events with UVCS were less across all settings (both p<0.0001). As IOP decreased, there was more AC stability and less iris movement observed with UVCS. There is a statistically significant relationship between iOCT ACD, microscope pupil area, and iOCT pupil diameter change (all p<0.0001). These results follow a similar trend to the previous SSV method, which demonstrate more AC stability with UVCS vs. CAS during occlusion break surge events.
Conclusions
AC stability can be objectively measured in the OR using iOCT. UVCS demonstrated better stability than CAS during simulated occlusion break, especially at lower IOP corroborating prior SSV method findings. Iris movement observed via surgical microscope may be a viable alternative to objectively and quantitatively assess the stability of the AC.