Purpose: To objectively compare the postocclusion vacuum surge among different phacoemulsification machines and devices.
Design: Experimental study.
Methods: Infiniti, Legacy, Millennium, and Sovereign were tested in an eye-bank eye. All the machines were tested with 20-gauge non-ABS tips, 430 mm Hg vacuum pressure, 24 ml/minute aspiration rate, peristaltic pump, and 75 cm bottle height. In addition, Infiniti and Legacy were also tested with 20-gauge bypass tips (ABS), 125 cm bottle height, and 40 ml/minute flow rate. We also tested 19-gauge tips with Infiniti and Sovereign and the venturi pump for Millennium.
Results: Significant differences were found between all the machines tested with Millennium peristaltic generating the least and Millennium Venturi the most surge. ABS tips significantly decreased the surge for Legacy but not for Infiniti. Cruise Control (CC) had a significant effect on Sovereign but not on Millennium. Increasing the bottle height decreased surge while increasing the flow increased surge for both Infiniti and Legacy. The 19-gauge tips increased surge for both Infiniti and Sovereign.
Conclusions: Surge varied over a range of 40 microm to more than 2 mm. ABS and CC decrease surge, especially when the machine is not functioning near the limits of surge prevention. Certain parameters, such as a 19-gauge tip and high flow, dramatically increased surge, whereas elevating the bottle ameliorates it. Understanding the impact of all these features will help in minimizing the problem.