Fluidics and Heat Generation of Alcon Infiniti and Legacy, Bausch & Lomb Millennium, and Advanced Medical Optics Sovereign Phacoemulsification Systems

Purpose

To study heat generation, vacuum, and flow characteristics of the Alcon Infiniti and Bausch & Lomb Millennium with results compared with the Alcon Legacy and advanced medical optics (AMO) Sovereign machines previously studied.

Design

Experimental study.

Methods

Heat generation with continuous ultrasound was determined with and without a 200-g weight. Flow and vacuum were determined from 12 to 40-ml/min in 2-ml/min steps. The impact of a STAAR Cruise Control was also tested.

Results

Millennium created the most heat/20% of power (5.67 ± 0.51°C unweighted and 6.80 ± 0.80°C weighted), followed by Sovereign (4.59 ± 0.70°C unweighted and 5.65 ± 0.72°C weighted), Infiniti (2.79 ± 0.62°C unweighted and 3.96 ± 0.31°C weighted), and Legacy (1.99 ± 0.49°C unweighted and 4.27 ± 0.76°C weighted; P < .0001 for all comparisons between machines except Infiniti vs Legacy, both weighted). Flow studies revealed that Millennium Peristaltic was 17% less than indicated (P < .0001 to all other machines), and all other machines were within 3.5% of indicated. Cruise Control decreased flow by 4.1% (P < .0001 for same machine without it). Millennium Venturi had the greatest vacuum (81% more than the least Sovereign; P < .0001), and Cruise Control increased vacuum in a peristaltic machine 35% more than the Venturi system (P < .0001).

Conclusions

Percent power is not consistent in regard to heat generation, however, flow was accurate for all machines except Millennium Peristaltic. Restriction with Cruise Control elevates unoccluded vacuum to levels greater than the Venturi system tested.