Efficacy of Cruise Control in controlling postocclusion surge with Legacy and Millennium venturi phacoemulsification machines

Purpose

To determine the efficacy of the Cruise Control surge-limiting device (Staar Surgical) with phacoemulsification machines known to have high levels of surge.

Setting

John A. Moran Eye Center Clinical Laboratories.

Methods

In an in vitro study, postocclusion anterior chamber depth changes were measured in fresh phakic human eye-bank eyes using the Alcon Legacy and Bausch & Lomb Millennium venturi machines in conjunction with the Staar Cruise Control device. Both machines were tested with 19-gauge non–Aspiration Bypass System tips at high-surge settings (500 mm Hg vacuum pressure, 75 cm bottle height, 40 mL/min flow rate for the Legacy) and low-surge settings (400 mm Hg vacuum pressure, 125 cm bottle height, 40 mL/min flow rate for the Legacy). Adjusted parameters of flow, vacuum, and irrigation were used based on previous studies to create identical conditions for each device tested. The effect of the Cruise Control device on aspiration rates was also tested with both machines at the low-surge settings.

Results

At the high setting with the addition of Cruise Control, surge decreased significantly with the Legacy but was too large to measure with the Millennium venturi. At the low setting with the addition of Cruise Control, surge decreased significantly with both machines. Surge with the Millennium decreased from more than 1.0 mm to a mean of 0.21 mm ± 0.02 (SD) (P<.0001). Surge with the Legacy decreased from a mean of 0.09 ± 0.02 mm to 0.05 ± 0 mm, a 42.9% decrease (P<.0001). The Millennium had the highest surge and aspiration rate before Cruise Control and the greatest percentage decrease in the surge and aspiration rates as a result of the addition of Cruise Control.

Conclusions

In the Legacy machine, the Cruise Control device had a statistically and clinically significant effect. Cruise Control had a large effect on fluidics as well as surge amplitude with the Millennium machine. The greater the flow or greater the initial surge, the greater the impact of the Cruise Control device.