Efficiency of venturi vs peristaltic-based phacoemulsification in femtosecond laser cataract surgery.

Purpose: To compare the efficiency of peristaltic vs venturi vacuum platforms when applied to femtosecond-treated cataract.

Setting: Outpatient Eye Center, Mercy Health System, Springfield, Missouri.

Design: This is a prospective randomized controlled trial of 111 patients with moderate nuclear sclerosis scheduled for bilateral routine laser cataract surgery (LCS) ( ClinicalTrials.gov ; NCT03970525).

Methods: Patients were randomized to receive surgery in 1 eye with a peristaltic system and the other with a venturi system. The vacuum and phacoemulsification power were the same for both systems. The primary outcomes were phacoemulsification energy (EFX), ultrasound time (UST), phacoemulsification in/out time (PIOT), surgery time (speculum in/out time), and endothelial cell count (ECC).

Results: The type of vacuum/phacoemulsification system used during LCS had a significant impact on the 4 procedural outcomes. Specifically, EFX, UST, PIOT, and total microscope time (speculum in/out case time) were lower when the venturi system was used compared with the peristaltic system ( t (100) = -4.28, P < .001). The vacuum system used did not affect the uncorrected distance visual acuity, corrected distance visual acuity, or central cornea thickness. ECC decreased by 6.38% with venturi and 8.32% with peristaltic ( t (87) = 1.19, P = .235). There were no complications.

Conclusions: Venturi-based phacoemulsification was more efficient than peristaltic, based on energy and time, when used for removal of femtosecond-treated cataract.