Measuring rectilinear flow within the anterior chamber in phacoemulsification procedures.

PURPOSE

To measure and photograph rectilinear flow generated in an anterior chamber model during different power phases of phacoemulsification.

SETTING

Oki Eye Surgery Center, Tokyo, Japan.

METHODS

An ultrasound (US) needle was fitted to a Sovereign WhiteStar (AMO) phacoemulsification unit. The sleeved needle was inserted into a silicone test chamber filled with balanced salt solution with glutation (BSS Plus). An LV-1610 laser Doppler vibrometer (Ono-Sokki) captured and processed the velocity and displacement of vibrations on the surface of the test chamber. Measurements were processed in a CF-520 Fast Fourier Transform (FFT) analyzer with the results shown in real time on the FFT analyzer and displayed on a computer monitor using 3-dimensional software. Four US delivery modes were measured: WhiteStar DB, WhiteStar CF, continuous mode, and short-pulse mode at 6 pulses per second (pps). Flow and vacuum were set at 20 cc/min and 200 mm Hg, respectively, and US power was 20% and 50%. Schlieren photography of the fluid flow was performed with an ultra-high-speed Memrecam fx 6000 camera (NAC Image Technology).

RESULTS

The peak vibration velocity (m/s) and displacement at the distal end of the test chamber were greatest for continuous mode, followed by short pulse (6 pps), WhiteStar DB, and WhiteStar CF, in descending order. At 20% power, the US needle generated a peak velocity of 8.64 x 10(-3) m/s in continuous mode, 7.30 x 10(-3) m/s in short-pulse mode, 5.03 x 10(-3) m/s in DB mode, and 3.74 x 10(-3) m/s in CF mode. At 50% power, the US needle generated a peak velocity of 12.8 x 10(-3) m/s in continuous mode, 10.9 x 10(-3) m/s in short-pulse mode, 8.52 x 10(-3) m/s in DB mode, and 6.37 x 10(-3) m/s in CF mode. Schlieren photography showed the greatest wave speed, intensity, and turbulence in continuous mode and the least with the WhiteStar modes.

CONCLUSIONS

Peak vibration velocity and amplitude of displacement were less with the WhiteStar delivery modes than with continuous power or short-pulse modes. A similar reduction was seen in the rectilinear flow under Schlieren photography. Attenuation of rectilinear flow and turbulence patterns may have clinical implications for the corneal endothelium during phacoemulsification.