Legacy AdvanTec and Sovereign WhiteStar: a wound temperature study.

OBJECTIVE

To assess the wound temperature of the Sovereign WhiteStar (S-WS) (AMO) and Legacy AdvanTec (L-ADV) (Alcon) phacoemulsification systems.

METHODS

John A. Moran Eye Center, Health Sciences Center, University of Utah, Salt Lake City, Utah, USA.

METHODS

Phacoemulsification using 20-gauge, 30-degree straight tips with the L-ADV and S-WS systems was performed in fresh cadaver eyes. The power was set at 50%, and aspiration was 12 mL/min; the L-ADV was run at 15 pulses per second (pps) and the S-WS at WS CF (6 milliseconds on, 12 milliseconds off). Temperature was measured at 5-second intervals for 60 seconds using a microthermistor placed in the wound. The phaco tip was angled 30 degrees to increase wound-tissue contact. At 10 seconds, the flow was clamped to simulate occlusion. Five runs, sleeved and unsleeved, were averaged for the phaco tip.

RESULTS

The mean temperature was significantly higher with L-ADV than with S-WS (from 10 seconds on in the sleeved condition and from 5 seconds on in the unsleeved condition after the aspiration line was clamped). In 2 of 5 sleeved runs and 4 of 5 unsleeved runs, the L-ADV handpiece decreased power as the temperature increased. One run with the L-ADV with sleeve showed signs of wound burn. There were no signs of wound burn with the S-WS. The highest temperature recorded was 57.5 degrees C with the L-ADV and 38.6 degrees C with the S-WS. Power tests showed L-ADV protected the stroke length and S-WS had constant power except in air where it increased power.

CONCLUSIONS

There was less increase in wound temperature over time with the S-WS than with the L-ADV system in sleeved and unsleeved simulated surgery in human eye-bank eyes. Because the ultrasound handpieces respond differently under different load scenarios, meaningful comparisons of pulsing features are difficult to create.