| Purpose: To evaluate the efficacy of custom control software (CCS)(Millennium microsurgery system, Bausch&Lomb) in reducing the phacoemulsifier energy used in cataract surgery. Methods: 120 eyes of cataract patients underwent phaco surgery by one surgeon and were divided into two groups - surgery was performed using the existing common software (control group) or CCS (CCS group) randomly. The density of cataract was evaluated by Emery classification into grade II, III and IV. For each group, there are 20 eyes in each grade. The average phaco power and elapsed phaco time, and absolute phaco time (APT = Average Power x Elapsed Phaco time) were compared after surgery, in the two groups. Result: A reduction in the phaco power used in the CCS group was noted compared to the control group. For the grade II, III and IV cataracts, the APT was 1.7 +/- 0.7 secs vs 3.1 +/- 1.7 secs,(p=0.0014), 3.4 +/- 1.6 secs vs 6.4 +/- 4.0 secs ( p=0.003), and 6.6 +/- 3.3 secs vs 12.2 +/- 5.0 secs (p=0.0001) in the CCS group and the control groups respectively. The average phaco time was also much shorter in the CCS group than the control groups 31.7 +/- 14.2 sces vs 50.7 +/- 17.1 secs (p=0.0004), 38.9 +/-14.5 secs vs 75.0 +/- 32.9 secs (p=0.00006) and 67.5 +/- 34.0 secs vs 106.4 +/- 40.6 secs (p=0.002) in the grade II, III and IV cataracts. The average phaco power was significantly lower in the CCS group in grade IV patients: 9 +/- 3% vs 11 +/- 2% (p=0.02). Conclusions: CCS provides custom power modulation that enhances control of phaco power, improved energy delivery efficiency, increases fragment followability and reduces phaco power use.
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