To assess intraoperative thermal levels at the wound site during divide-and-conquer phacoemulsification with the Sovereign with WhiteStar (SWS) system or the Legacy with AdvanTec and NeoSoniX (LAD) system.

Prospective, randomized, parallel-group, comparative study.

Twenty-six subjects from a private clinical practice underwent divide-and-conquer phacoemulsification with either the SWS system or the LAD system. CB/CF settings (60%/33% duty cycles) were utilized with SWS and 12 pulses per second with the LAD system. Key criteria assessed were peak wound-site temperature, mean temperature change at the wound site, effective phaco time, average phaco power, procedure time, amount of BSS used, and surgical complications.

Mean temperature change at the wound site was greater for the LAD than the SWS group. There was a statistically significant difference (P = .0002) in mean peak wound temperatures, with the LAD group having higher mean peak temperatures (42.47 ± 5.33°C) than the SWS group (36.59 ± 1.33°C). Highest wound-site temperature was 51°C for the LAD group and 39.3°C for the SWS group. A statistically significant difference (P = .0031) in mean peak temperature was found between the LAD and SWS systems for subjects with a cataract density of 4: higher mean peak temperatures were observed for LAD patients with a cataract density of 4.

Our findings show that phacoemulsification using the SWS system results in lower peak temperatures and less temperature change at the phaco wound site compared with the LAD system.