The efficiency of venturi versus peristaltic based phacoemulsification in femtosecond laser cataract surgery: Venturi vs peristaltic based phacoemulsification for cataract

Purpose: To compare the efficiency of peristaltic vs venturi vacuum platforms when applied to the femtosecond treated cataract.

Setting: Outpatient Eye Center, Mercy Health System, Springfield, MO, USA.

Design: This is a prospective randomized controlled trial of 111 patients with moderate nuclear sclerosis scheduled for bilateral routine laser cataract surgery (clinicaltrials.gov; NCT03970525).

Methods: Patients were randomized to receive surgery in one eye with a peristaltic system and the other with a venturi system. The vacuum and phaco power were the same for both systems. The primary outcomes were EFX, UST (ultrasound time), PIOT (phaco in/out time), surgery time (speculum in/out time), and the ECC (endothelial cell count).

Results: The type of vacuum/phacoemulsification system used during laser cataract surgery had a significant impact on the four procedural outcomes. Specifically, phacoemulsification energy (EFX), ultrasound time (UST), phaco tip in/out time (PIOT), and total microscope time (speculum in/out case time) were lower when the venturi system was used compared to the peristaltic system (t(100)=-4.28, p <.001). The vacuum system used did not impact the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) or central cornea thickness (CCT). ECC decreased 6.38% with venturi and 8.32% with peristaltic (t(87) = 1.19, p = .235). There were no complications.

Conclusion: Venturi-based phaco was more efficient than peristaltic, based on energy and time, when used for removal of the femtosecond treated cataract.