Comparison among three different systems of forced infusion during phacoemulsification
First Author: C.Bellucci ITALY
Co Author(s): R. Bellucci
Different machines offer instantaneous control of the infusion pressure during phacoemulsification surgery, with the purpose of stabilizing the anterior chamber, avoiding depth oscillation and surge. Three of them were analyzed in this study, and tested in clinical practice. The Active Fluidics system squeezes the soft plastic BSS bottle to increase irrigation as aspiration increases (fluid pump). The Adaptive Fluidics system and the Dynamic Fluidics system inject compressed air into the rigid BSS bottle to increase irrigation as vacuum increases (vacuum pump).
private practice Verona, Italy
The three systems have been tested in clinical practice in 3 groups of 20 eyes each, operated on for grade II-III cataracts. IOP value was set at 40 mm Hg, flow rate was set at 30 cc/min (fluid pump), and vacuum was set at 500 mmHg. US delivery was torsional 60% / longitudinal 20% with the fluid pump, and micropulse 10% with the vacuum pump. Microincision phaco needles were adopted in all cases. The time required for nucleus removal, the amount of BSS employed, and the evident chamber oscillations during surgery were recorded.
The mean time required for nucleus removal was between 103 and 126 sec for the three machines. The amount of BSS employed was lower with the Active Fluidics (77+/-18 ml vs. 105+/-33 ml and 98+/-27 ml. Six episodes of chamber oscillation were recorded with the Active Fluidics system, but in no case did chamber collapse occur
All the tested systems proved effective in counteracting the shallowing of the anterior chamber during phacoemulsification. The systems associated with vacuum pumps provided better stability of the anterior chamber, but IOP may peak during occlusion. The system associated with the fluid pump was associated with lower BSS use, and avoided IOP peaks, but did not compensate completely for surge.