Background: Occlusion break surge during phacoemulsification cataract surgery can lead to potential surgical\ncomplications. The purpose of this study was to quantify occlusion break surge and vacuum rise time of current\nphacoemulsification systems used in cataract surgery.\nMethods: Occlusion break surge at vacuum pressures between 200 and 600 mmHg was assessed with the Infiniti�®\nVision System, the WhiteStar Signature�® Phacoemulsification System, and the Centurion�® Vision System using\ngravity-fed fluidics. Centurion Active FluidicsTM were also tested at multiple intraoperative pressure target settings.\nVacuum rise time was evaluated for Infiniti, WhiteStar Signature, Centurion, and Stellaris�® Vision Enhancement\nsystems. Rise time to vacuum limits of 400 and 600 mmHg was assessed at flow rates of 30 and 60 cc/minute.\nOcclusion break surge was analyzed by 2-way analysis of variance.\nResults: The Centurion system exhibited substantially less occlusion break surge than the other systems\ntested. Surge area with Centurion Active Fluidics was similar to gravity fluidics at an equivalent bottle height.\nAt all Centurion Active Fluidics intraoperative pressure target settings tested, surge was smaller than with\nInfiniti and WhiteStar Signature. Infiniti had the fastest vacuum rise time and Stellaris had the slowest. No\nsystem tested reached the 600-mmHg vacuum limit.\nConclusions: In this laboratory study, Centurion had the least occlusion break surge and similar vacuum rise\ntimes compared with the other systems tested. Reducing occlusion break surge may increase safety of\nphacoemulsification cataract surgery
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