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The following is a summary of “Evaluation of the Occlusion Break Surge Volume in Five Different Phacoemulsification Systems,” published in the April 2025 issue of Clinical Ophthalmology by Yalamanchili et al. 

Researchers conducted a retrospective study to compare surge volumes following occlusion breaks across 5 phacoemulsification systems.  

They used a mechanical spring-eye model to evaluate the Legion^TM Vision System with Single Use Fluidics Management System (FMS) (LEG), Infiniti^TM Vision System with Intrepid^TM Plus Fluidics Management System (INF), Whitestar Signature Pro^® with OPO73 pack (WSP), Compact Intuitiv^® with OPO80 pack (CIS), and Stellaris PC^® with StableChamber cassette (SPC). The transient occlusion break surge volumes were examined across settings of intraocular pressure (IOP) (30–80 mmHg), vacuum limit (300–650 mmHg), and aspiration rates (20 or 40 cc/min) and recorded oscilloscope waveforms for stable flow, full occlusion, occlusion break, and recovery phases. The oscilloscope data was converted into volumetric and pressure values and generated fitted average surge traces for each condition and applied an interpolation algorithm to predict transient surge responses.  

The results showed that the lowest surge volumes for all phacoemulsification systems occurred at the highest IOP of 80 mmHg and the lowest vacuum limit of 300 mmHg. Surge volume increased as vacuum limit rose and IOP decreased in LEG, INF, CIS, WSP, and SPC systems. At 60 mmHg IOP and 500 mmHg vacuum, occlusion break surge volumes in (μL [standard deviation]) were 70.4 [8.1] for LEG, 87.4 [9.7] for INF, 85.8 [7.2] for CIS, 69.5 [5.0] for WSP, and 151.7 [20.2] for SPC. A Games-Howell post-hoc test identified three statistically distinct groups: Group A (LEG/WSP), Group B (CIS/INF), and Group C (SPC).  

Investigators concluded that the Legion system demonstrated comparable or lower predicted surge volume after occlusion breaks compared to the other phacoemulsification systems evaluated, and these reductions in occlusion break surge volumes were expected to decrease the rate of complications and lead to improved outcomes in the clinical cataract surgery setting. 

Source: dovepress.com/evaluation-of-the-occlusion-break-surge-volume-in-five-different-phaco-peer-reviewed-fulltext-article-OPTH