Comparison of Long Micro and Continuous Phaco Pulse-Type Technology

Tuesday, April 21, 2015: 1:31 PM
Room 4 (San Diego Convention Center)
Gareth Lance Gardiner, BS
Kevin Garff
Isha Gupta, BS
Gregory D. Kramer, MD
Mohammed A. Farukhi, MD
Brian C. Stagg, MD
Brian E. Zaugg, MD
Randall J. Olson, MD

Purpose
To evaluate pulse-type technology (long, micro, and continuous) used to remove lens fragments during cataract surgery.

Methods
Porcine lens nuclei were soaked in 10 ml of 10% neutral buffered formalin for 2 hours and placed in a 10 ml balanced salt solution for 24 hours to increase uniformity.  Lenses were then cut into 2 mm x 2 mm cubes and placed into a pool of BSS within a moisture chamber, no more than 36 hours after cutting.  Two aspiration and two vacuum settings were assessed: moderate flow and vacuum (30 ml/min and 300 mmHg; LoFloVac) and high flow and vacuum (50 ml/min and 500 mmHg; HiFloVac).

Results
There was a significant difference in efficiency which favored micropulse technology compared with combined long pulse and continuous pulse in HiFloVac at 80% power (p = 0.018) and between combined long pulse and continuous pulse versus micropulse in HiFloVac at 20% power 9p = 0.019). Additionally, LoFlowVac micropulse was more efficient than continuous pulse (19.7%; p < 0.0001) and long pulse ( 22.7%; p < 0.0001).  Finally, continuous and long pulses were not significantly different from one another and there was a significant difference in chatter rates between HiFloVac and LoFloVac when all results were compared ( p < 0.0001).

Conclusion
Micropulse technology was preferable compared to continuous and long pulse at moderate flow (30 ml/min) and vacuum (300 mmHg), but not at high flow (50 ml/min) and vacuum (500 mmHg).  Chatter events were observed infrequently at a higher setting and all modalities were more efficient than at the lower setting.