Target IOP control in passive vs active phacoemulsification infusion fluidics

Session Details

Session Title: Cataract Surgery Complications Management. OVDs, Cataract Surgery Equipment

Session Date/Time: Monday 07/09/2015 | 08:00-10:00

Paper Time: 09:27

Venue: Main Auditorium

First Author: : K.Miller USA

Co Author(s): :    C. Nicoli   R. Dimalanta                 

Abstract Details

Purpose:

To compare the ability of phacoemulsification systems with passive versus active infusion fluidics to maintain target intraocular pressures (IOPs) with varying aspiration flow rates.

Setting:

A laboratory at Alcon Research in Lake Forest, California

Methods:

The Alcon Infiniti and Centurion Vision Systems were used for these experiments. The hand-piece of each machine was inserted into an acrylic test chamber with pressure measurement ports. Both machines were operated in a passive or gravity feed irrigation mode. The Centurion system was also operated in an active control mode where a bag of irrigant is squeezed between two plates to generate infusion pressure. Bottle heights and/or bag pressures were selected to provide equal test chamber pressures at zero aspiration flow. Steady state IOPs were measured in the test chamber as the aspiration flow rate was gradually increased.

Results:

When the two systems were operated in passive mode, the IOP in the test chamber decreased by approximately 15 mmHg with each 15 cc/min increase in aspiration flow (or 1 mmHg per 1 cc/min) regardless of bottle height or starting IOP. The system with active fluidics maintained the target IOP at low to moderate flow rates (within 0.02 mmHg per cc/min), but experienced a slight decrease in IOP at the highest flow rate tested (maximum drop = 6.0 mmHg).

Conclusions:

At equivalent target IOPs, the two passive systems lost IOP as a function of increasing aspiration flow. The system with active fluidics provided a constant steady state IOP across all but the very highest flow rates tested. This finding probably translates to better anterior chamber maintenance during cataract surgery using an active control system.

Financial Interest:

One of the authors is employed by a for-profit company with an interest in the subject of the presentation, One of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, One of the authors research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, One of the authors receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented