Volume-based characterization of postocclusion surge.

Abstract

PURPOSE: To propose an alternative method to characterize postocclusion surge using a collapsible artificial anterior chamber to replace the currently used rigid anterior chamber model. SETTING: Fundación Oftamológica Los Andes, Santiago, Chile. METHODS: The distal end of a phacoemulsification handpiece was placed inside a compliant artificial anterior chamber. Digital recordings of chamber pressure, chamber volume, inflow, and outflow were performed during occlusion break of the phacoemulsification tip. The occlusion break profile of 2 different consoles was compared. RESULTS: Occlusion break while using a rigid anterior chamber model produced a simultaneous increase of chamber inflow and outflow. In the rigid chamber model, pressure decreased sharply, reaching negative pressure values. Alternatively, with the collapsible chamber model, a delay was observed in the inflow that occurs to compensate the outflow surge. Also, the chamber pressure drop was smaller in magnitude, never undershooting below atmospheric pressure into negative values. Using 500 mm Hg as vacuum limit, the Infiniti System (Alcon) performed better that the Legacy (Alcon), showing an 18% reduction in peak volume variation. CONCLUSIONS: The collapsible anterior chamber model provides a more realistic representation of the postocclusion surge events that occur in the real eye during cataract surgery. Peak volume fluctuation (mL), half volume recovery time(s), and volume fluctuation integral value (mL x s) are proposed as realistic indicators to characterize the postocclusion surge performance. These indicators show that the Infiniti System has a better postocclusion surge behavior than the Legacy System.