Toggle Main Menu Toggle Search

Open Access padlockePrints

Effect of high-vacuum setting on phacoemulsification efficiency

Lookup NU author(s): Professor David SteelORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


© 2017 ASCRS and ESCRS Purpose To evaluate the effect of a high-vacuum setting versus a low-vacuum setting on the efficiency of phacoemulsification. Setting Sunderland Eye Infirmary, Sunderland, United Kingdom. Design Prospective clinical trial. Methods Consecutive patients having cataract surgery in 2014 were recruited. Cataract surgery was performed by 2 experienced surgeons using a phacoemulsification machine with monitored forced infusion. The cataractous lens was split into 2 heminuclei using the stop-and-chop technique; in 1 heminucleus, phacoemulsification and aspiration used a high-vacuum setting (600 mm Hg; treatment group) and in the other heminucleus, a low-vacuum setting (350 mm Hg; control group). The high and low settings were alternated by case per the operating list to reduce surgeon bias. The main outcome measures were cumulative dissipated energy (CDE) and active heminucleus removal time. Results One hundred sixty patients (160 eyes) were enrolled in the study, and 158 were included in the analysis. The CDE per heminucleus was significantly lower with the high-vacuum setting than with the low-vacuum setting (mean 2.81 percent-seconds; 95% confidence interval (CI), 2.44-3.21 versus 3.81 percent-seconds; 95% CI, 3.38-4.20; P <.001). The active heminucleus removal time was significantly shorter in the high-vacuum group than the low-vacuum group (mean 27.77 seconds; 95% CI, 25.26-30.19 versus 33.59 seconds; 95% CI, 31.07-35.92; P <.001). The observed differences were independent of the surgeon, patient age and sex, incision size, and nucleus density. No intraoperative complications were observed in either group. Conclusion A high-vacuum setting improved phacoemulsification efficiency using an active fluidics system and torsional phacoemulsification.

Publication metadata

Author(s): Ting DSJ, Rees J, Ng JY, Allen D, Steel DHW

Publication type: Article

Publication status: Published

Journal: Journal of Cataract and Refractive Surgery

Year: 2017

Volume: 43

Issue: 9

Pages: 1135-1139

Print publication date: 01/09/2017

Online publication date: 06/10/2017

Acceptance date: 05/07/2017

Date deposited: 04/03/2018

ISSN (print): 0886-3350

ISSN (electronic): 1873-4502

Publisher: Elsevier Inc.


DOI: 10.1016/j.jcrs.2017.09.001


Altmetrics provided by Altmetric