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Effect of high-vacuum setting on torsional and longitudinal phaco-chop

Poster Details

First Author: I.Perez Gudino MEXICO

Co Author(s):    R. Gonzalez Salinas   M. Massaro                 

Abstract Details


To evaluate the effect of a high-vacuum setting versus a low-vacuum setting on the efficiency of phacoemulsification and corneal cell density in dense cataracts.


Asociación Para Evitar la Ceguera, Mexico City, Mexico.


We recruited consecutive patients who had cataract surgery with LOCS 4-5. Cataract surgery was performed by 2 experienced surgeons using Centurion ®. The cataractous lens was split using phaco-chop. We had 3 groups: G1: Longitudinal phaco power (LPP) of 100%, torsional phaco power (TPP) 100% and vacuum (V) of 700 mmHg. G2: LPP: 50%, TPP: 50% and V: 700 mmHg. G3: LPP: 50%, TPP: 50% and V: 350 mmHg. The main outcome measures were cumulative dissipated energy (CDE), corneal cell density and active heminucleus removal time.


So far, twenty-nine individuals have been included in the protocol. The majority have been women (n= 15, 51.7%); the median age of the cohort was 73 years (IQR 63.5-79.5). The preoperative ophthalmological characteristics showed no difference between the groups according to endothelial cell density (p=0.35); coefficient of variation (p=0.25), corneal thickness (p=0.25) and hexagonality (p=0.18). Regarding the transoperative measurements with Centurion®, group 1 and 2 used less ultrasound time (65.6 and 26 sec vs 98.25 in group 3) and had a lower amount of accumulated dissipated energy (10.92 and 7.54 vs 17.31 in group 3); but no statistical significance was documented (p=1; p=0.06, respectively). The total vacuum time between the groups was 5.16 min in group 1; 3.53 in group 2 and 4.28 in group 3 (p=1).


This is preliminary data. According to the results, there is no benefit in using high vacuum values in the efficacy of phacoemulsification in hard cataracts. Until now, the use of high vacuum values had not shown benefit in the treatment of hard cataracts. This study is limited by the actual sample size, but more patients are being recruited.

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