Comparison of cumulative dissipated energy delivered by active-fluidic pressure control phacoemulsification system versus gravity-fluidics

Purpose: To compare the cumulative dissipated energy (CDE), aspiration time and estimated aspiration fluid utilized during phacoemulsification cataract surgery using two phacoemulsification systems. Methods: A total of 164 consecutive eyes of 164 patients undergoing cataract surgery, 82 in the active-fluidics group and 82 in the gravity-fluidics group were enrolled in this study. Cataracts graded NII to NIII using LOCS II were included. Each subject was randomly assigned to one of the two platforms with a specific configuration: the active-fluidics Centurion ^® phacoemulsification system or the gravity-fluidics Infiniti ^® Vision System. CDE, aspiration time (AT) and the mean estimated aspiration fluid (EAF) were registered and compared. Results: A mean age of 68.3 ± 9.8 years was found (range 57–92 years), and no significant difference was evident between both groups. A positive correlation between the CDE values obtained by both platforms was verified (r = 0.271, R ² = 0.073, P = 0.013). Similarly, a significant correlation was evidenced for the EAF (r = 0.334, R ² = 0.112, P = 0.046) and AT values (r = 0.156, R ² = 0.024, P = 0.161). A statistically significantly lower CDE count, aspiration time and estimated fluid were obtained using the active-fluidics configuration when compared to the gravity-fluidics configuration by 19.29, 12.10 and 9.29%, respectively (P = 0.001, P < 0.0001 and P = 0.001). Conclusions: The active-fluidics Centurion ^® phacoemulsification system achieved higher surgical efficiency than the gravity-fluidics Infiniti ^® IP system for NII and NIII cataracts.