Experimental study of occlusion break surge volume in 3 different phacoemulsification systems

Purpose: To evaluate surge volume after occlusion breaks in 3 different phacoemulsification systems. Setting: Alcon Research LLC, Lake Forest, California. Design: Experimental study. Methods: A mechanical spring eye model was used to test the Centurion with Active Sentry, WhiteStar Signature Pro, and Stellaris PC. Raw oscilloscope data were converted to volumetric and pressure measurements. Fitted average surge traces were generated for each test condition and used to develop an interpolation algorithm to predict transient occlusion break surge events. Two-dimensional heat maps were generated. Results: During occlusion break surge, the Centurion with Active Sentry had smaller aqueous volume losses than the WhiteStar or Stellaris PC. Maximum surge volumes within the mechanical spring eye model displacement limit were 74.7 mL, 157.5 mL, and 151.7 mL using Centurion with Active Sentry, WhiteStar, and Stellaris PC, respectively. In the aphakic state, heat maps showed that Centurion with Active Sentry had less than 20% aqueous volume loss across all vacuum limits and target intraocular pressure; WhiteStar and Stellaris PC systems had up to 35% and 50% aqueous volume losses, respectively, at the higher vacuum limits. In the phakic state, Centurion with Active Sentry had up to 30% aqueous volume loss and WhiteStar and Stellaris PC systems had up to 50% aqueous volume losses. In addition, predicted transient traces demonstrated that Centurion with Active Sentry had the lowest percentage simulated aqueous volume loss compared with WhiteStar or Stellaris PC. Conclusions: Centurion with Active Sentry had lower aqueous volume losses after occlusion break than WhiteStar and Stellaris PC systems at all surgical settings.