Purpose: The aim of this study was to use calorimetry to understand the difference in energy transferred by three phacoemulsification surgical platforms to the eye.
Patients and methods: A phacoemulsification tip was lowered into a double-walled calorimeter filled with distilled water. The foot pedal was depressed for 30 seconds and the change in temperature of the water was measured by a temperature probe. Three phacoemulsification systems were compared: the Alcon Centurion, Johnson & Johnson Veritas and Oertli CataRhex 3. The following conditions remained constant across trials and platforms: continuous longitudinal ultrasound, flow rate 12mL/min, vacuum 0mmHg, and clamped inflow and outflow tubing. The different platforms were directly compared at 20%, 40%, 60%, 80% and 100% power.
Results: A two-way ANOVA found a significant difference (P < 0.001) in overall energy output across all trials between the CataRhex 3, Centurion and Veritas with an F value of 63.97 and two degrees of freedom.
Conclusion: Given identical settings, the amount of energy produced was significantly different across phacoemulsification platforms. This data can aid surgeons' understanding of how power level by surgical platform can impact the amount of energy introduced into the anterior segment during cataract surgery.
Keywords: calorimetry; cataract; complications; surgery.
Cataract surgery is one of the most commonly performed surgical procedures in the United States. The most common surgical technique used to remove cataracts is called phacoemulsification (phaco), which utilizes ultrasound energy to break up and remove cataracts. Utilizing phaco to emulsify cataracts is safe and effective; however, because of the delicate nature of the structures in the eye, the amount of ultrasound energy delivered during the surgery is an important consideration to avoid adverse outcomes. There are a variety of phaco platforms (machines) used for cataract surgery. While it is beneficial for surgeons to have many options of surgical platforms, proprietary engineering makes it difficult to know how these surgical platforms compare to one another, especially in important variables such as energy delivery to the eye. To date, it has been unknown how the amount of energy delivered by these phaco platforms differs, if at all, when using identical settings during surgery. We did this study to find out if there are energy differences. To do this research, our lab used calorimetry, which is a way of measuring energy transfer, to compare three different surgical platforms at the same settings. We found a statistically significant difference in amount of energy between these surgical platforms. These results are important because they may help surgeons to understand that the amount of energy delivered during cataract surgery will be different depending on which surgical platform they are using and help to prevent adverse outcomes caused by delivering too much energy to the eye.
© 2025 Nelson et al.