Comparison of 2 Phacoemulsification Vision Systems in Microcoaxial Cataract Surgery
Purpose
To evaluate the safety and efficiency of Centurion Vision System with Active Fluidics in sub-2mm micro coaxial cataract surgery in comparison with the conventional Infiniti Vision System with modified FMS.
Methods
Grade II and III cataract were prechopped through a 1.8mm corneal incision and removed by the Harmonyx tip with Nano sleeve using OZil mixed burst mode. Aspiration time, BSS consumption, CDE, total operation time and corneal endothelial cell loss were analyzed. To keep sufficient irrigation into the anterior chamber, the original 3.0mm PVC irrigation tubes were replaced by 5.0mm silicone tubes in Infiniti, while the original Active Fluidics FMS was used in Centurion. The aspiration flow rate was most comfortably set at 35ml/min in Infiniti and 50ml/min in Centurion. The vacuum setting was 650+mmHg with bottle height of 149cm in Infiniti and 700+mmHg with 30 to 110mmHg IOP in Centurion.
Results
There was almost no occlusion surge and the anterior chamber was extremely stable in Centurion. The aspiration time, CDE and BSS consumption for grade II nuclei, which were prechopped by Karate technique, were 32.5±14.7sec/ 2.54±0.92 / 19.0±7.4ml in Centurion and 36.2±17.1sec/ 2.56±0.98 /18.3±8.6ml in Infiniti. For grade III cataract, which required the counter prechop technique, 35.0±11.8sec/ 4.30±1.40/ 21.5±7.9ml in Centurion and 44.9±11.3sec/ 5.56±1.63/ 22.7±6.1ml in Infiniti. In both nuclear density, the aspiration time and CDE were less in Centurion. Stable anterior chamber was not maintained if the bottle height was reduced in Infiniti, while low pressure surgery at 30mmHg IOP was possible through a 1.8mm incision in Centurion.
Conclusion
To attain sub-2mm micro coaxial surgery with Infiniti, some modification of the irrigation system was mandatory. By Centurion with Active Fluidics, the anterior chamber stability was remarkably improved. At higher flow rate, the aspiration time as well as the CDE was reduced and even at the IOP of 30mmHg, sub-2mm surgery was possible. For safe and efficient micro coaxial cataract surgery, Centurion with Active Fluidics is superior to the conventional Infiniti Vision System.