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MP Rubin, KM Goins, RD Jager, CV Albanis, M Dwyer, JT Ernest; Comparison of Phacoemulsification Complication Rates in a University Setting Using Venturi and Peristaltic Machines . Invest. Ophthalmol. Vis. Sci. 2002;43(13):370.
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Purpose: While phacoemulsification has proven to be a highly successful procedure, surgical outcomes analysis remains critical to improve surgical techniques and teaching methods in the aims of bettering the quality of patient care. In particular, quantifying the role of equipment changes and mechanical settings will help optimize surgical performance. Methods: A retrospective analysis of 2495 consecutive phacoemulsification cataract extraction cases was performed (104 venturi driven procedures and 2391 peristaltic driven procedures), and the incidence of vitreous loss with posterior capsule tear was calculated. The Stortz Premiere was used in all venturi cases, while the Alcon Legacy was used in all of the peristaltic cases. Chi-squared analysis was performed to ensure the statistical significance of the results. Results: From fiscal year (FY) 1993 to FY 2000, vitreous loss with a posterior capsule tear occurred during phacoemulsification in 102 eyes (4.09%). From FY 1993 to 1994, vitreous loss with posterior capsule tear occurred in 17 of 104 eyes (16.35%) using the Storz Premiere venturi unit. Since FY 1995, vitreous loss with posterior capsule rupture has occurred in 85 of 2391 eyes (3.55%) using the Alcon Legacy peristaltic unit. Conclusion: A statistically significant decrease in posterior capsule tears with vitreous loss has occurred since FY 1995 following the change from venturi to peristaltic driven phacoemulsification (P<0.001). We suspect that the higher inherent vacuum levels present in the venturi driven system may have led to an increased incidence of posterior capsule tears and vitreous loss in the beginning resident surgeon. Other factors that were analyzed and may be important include attending surgeon experience, phacoemulsification technique, machine parameters used, and the content of preparatory phacoemulsification courses.
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