Clinical Ophthalmology (Dec 2018)
Prospective randomized comparative study between venturi and peristaltic pumps in WhiteStar Signature® phacoemulsification machine
Abstract
Wilson Takashi Hida,1–3 André Lins de Medeiros,1,2 André Gustavo de Araújo Rolim,1,2 Antonio Francisco Pimenta Motta,2,3 Danilo Varela Kniggendorf,1,2 Rodrigo Lafetá Franco de Queiroz,1,2 Mário Augusto Pereira Dias Chaves,1,2 Pedro Carlos Carricondo,1,2 Celso Takashi Nakano,2,4 Walton Nosé5 1Cataract Sector, Hospital Oftalmológico de Brasília, Brasília, Federal District, Brazil; 2Cataract Sector, Centro de Estudos Oftalmológicos Renato Ambrósio, Brasília, Brazil; 3Cataract Sector, Universidade de São Paulo, São Paulo, Brazil; 4Cataract Sector, Hospital Santa Cruz, São Paulo, Brazil; 5Cataract Sector, Universidade Federal de São Paulo, São Paulo, Brazil Purpose: To compare intraoperative parameters between venturi and peristaltic pump in WhiteStar Signature® phacoemulsification machine using the bevel-down technique.Setting: Hospital Oftalmológico de Brasília, Brasília, Federal District, Brazil.Design: Prospective, comparative, patient-masked study.Methods: Three hundred eyes were randomly assigned to have a phacoemulsification procedure with WhiteStar Signature® using either peristaltic (n=150 eyes) or venturi (n=150 eyes) pumps by a single surgeon (WTH). Elliptical ultrasound setting and prefracture (prechop or preslice) techniques were used in all cases. Cataract nucleus density was graded using lens opacities classification system III and Pentacam Nucleus Staging classification. Clinical measurements included preoperative- and postoperative- corrected visual acuity, preoperative and 2-month postoperative endothelial cell counts, and preoperative and 1-day postoperative central corneal thickness. Intraoperative measurements at the end of the case were phaco time, fluid used, total case time, and Efx energy.Results: There were no statistically significant differences between groups regarding age, cataract density, and phaco time (P>0.05). Intraoperatively, we observed significantly less ultrasound energy (P=0.011), case time (P=0.0001), and balanced saline solution (P=0.001) usage in the venturi group. Clinically, both fluidic settings can provide similar clinical outcomes and visual recovery, regarding corrected distance visual acuity, endothelial cell count, and central corneal thickness.Conclusion: Our data show that to minimize fluid use, case time, and energy with the prefracture technique, the venturi pump was the most efficient system and was statistically superior to peristaltic pump. Keywords: venturi, peristaltic, phacoemulsification, cataract surgery, vacuum efficiency