Background: The objective of this study was to evaluate the effect of utilising larger lens cubes on phacoemulsification efficiency and chatter using 3 tips of different sizes and 2 ultrasound (US) approaches.
Methods: This was an in vitro laboratory study conducted at the John A. Moran Eye Center Laboratory, University of Utah, Salt Lake City, UT, USA. Porcine lens nuclei were formalin-soaked for 2 hours, then divided into either 2.0 mm or 3.0 mm cubes. 30 degree bent 19 G, 20 G, and 21 G tips were used with a continuous torsional US system; and straight 19 G, 20 G, and 21 G tips were used with a micropulse longitudinal US system. Efficiency and chatter were determined.
Results: Mean phacoemulsification removal time was higher with the 3.0 mm lens cube for all US variations and tip sizes. There were statistically significant differences between the 19 G and 21 G tips with micropulse longitudinal US using the 2.0 mm lens cube and the 3.0 mm lens cube, as well as with continuous transversal US using the 2.0 mm lens cube and the 3.0 mm lens cube. There was no significant difference between 19 G and 20 G tips with either lens cube size in either US approach. However, using both US approaches, trends were identical for both lens cube sizes in which the 19 G tips performed better than the 20 G and 21 G tips.
Conclusion: Regardless of lens size, the 19 G needle was the most efficient, with the fewest outliers and smallest standard deviations.