Impact of torsional micropulse on phacoemulsification efficiency and chatter

Abstract Objective Evaluate the effect of increasing ultrasound (US) power on chatter events and efficiency under both continuous and micropulse torsional US to reduce total cataract extraction times. Design In vitro laboratory study. Methods Porcine lens nuclei were incubated in formalin for 2hours and then cut into 2-mm cubes. Phacoemulsification was performed using the Centurion Vision System and Infiniti OZil handpiece with the balanced tip. Both US modalities were studied at 60%, 80%, and 100% power. Micropulse rate was 83 pulses per second with 50% on time. Each combination comprised 20 runs. Efficiency was considered as the total time for a cube to be emulsified; chatter was the number of times the lens fragment bounced off the tip. Results There was significant decrease in efficiency when power was increased from 60% to 100% (1.33–1.97 s; p p p  = 0.001). Conclusions Increasing power above 60% decreased efficiency under torsional micropulse US. We believe that this was due to the chatter increase observed with increasing US power. Torsional continuous US was significantly more efficient than micropulse US at 100% power.