Temperature profiles of sleeveless and coaxial phacoemulsification

Abstract

Purpose: To study the temperature profile at the corneal wound during 2 sleeveless techniques versus 2 coaxial phacoemulsification techniques.

Setting: Department of Ophthalmology, Meir Medical Center, Kfar Saba and Ein-Tal Eye Center, Tel-Aviv, Israel.

Design: Experimental study.

Methods: Thirty-six porcine eyes were randomized into 4 groups: Group 1: conventional coaxial system (3.0 mm incision); Group 2: coaxial microincision cataract surgery (MICS) system (2.2 mm incision); Group 3: bimanual MICS (1.1 mm incision); Group 4: sleeveless tri-MICS (1.1 mm incision) using a 19-gauge anterior chamber maintainer as the sole fluid source. Temperature measurements were taken using a thermocouple and an infrared thermal imaging system. Measurements were taken in 2 settings; that is, with and without occlusion.

Results: With no occlusion, corneal burns did not occur in any group. However, corneal temperatures were lower with the sleeveless systems (Groups 3 and 4) than with the coaxial systems (Groups 1 and 2) (P=.0003). When occlusion was induced, temperatures were kept constantly low in the sleeveless groups, whereas in the coaxial groups, temperatures increased rapidly, causing corneal burns within seconds. The mean temperature elevations at the incision sites were 39 °C, 48.5 °C, 13.6 °C, and 11.3 °C in Groups 1, 2, 3, and 4, respectively (P<.0001).

Conclusions: Sleeveless phacoemulsification maintained lower tissue temperatures than sleeved coaxial methods. During occlusion, fluid flow around the naked tip of the sleeveless systems prevented heat accumulation and corneal burns.