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Phacoemulsification is a critical element of cataract surgery and has the potential to cause corneal collagen contracture (CCC). This study aims to determine the thermal features of the Centurion (Alcon) phacoemulsification machine with 20 cc/min aspirational flow rate on four ophthalmic viscosurgical devices (OVDs).
The Alcon Centurion phacoemulsification machine was used with an Omega Temperature Gauge secured to the phaco sleeve. The Centurion was set to 68 cm IOP, 700+ mm/Hg vacuum, 20 cc/min aspiration, and 60% torsional power. Temperature was continuously recorded for 60 seconds. The phacoemulsifier was primed and 0.1 mL of OVD was added to the test chamber. Once the thermistor measured a consistent OVD temperature, the phaco pedal was engaged for 60 seconds and then removed. This procedure was then repeated 10 times for BSS alone and for each OVD. The increase in temperature from time zero was then compared for each OVD with the BSS results with Student-T testing. Significance was set at P<0.05.
BSS demonstrated an average 60 second increase of 2.82±0.45°C. Viscoat showed 2.36±0.93°C. Provisc showed 2.47±1.38°C. Discovisc showed 2.49±0.77°C. Healon 5 showed 3.02±0.94°C. While all OVDs showed higher temperatures at five and ten seconds compared to BSS, only Healon 5 and DisCoVisc were significantly different at five seconds (1.92±0.79 and 1.73±0.66 respectively) and only Healon 5 at ten seconds (1.54±0.43). None of the temperature increases over the control BSS were more than 1.0 degrees C.
With even a small amount of fluid flow, the heat created during ultrasound was minimal and not different than with BSS after just a few seconds. Only DisCoVisc and Healon 5 (highly viscous OVDs) showed an effect that was significantly different than BSS. Therefore, OVD induced wound burns are not a concern if there is any flow through the system.