OBJECTIVETo compare the efficiency of venturi and peristaltic pump phacoemulsification systems in patients undergoing routine laser cataract surgery. DESIGNSingle center, non-randomized clinical study. PARTICIPANTSThe study compared consecutive eyes with moderate nuclear sclerosis undergoing routine laser cataract surgery at the Outpatient Eye Center, Mercy Health System, Springfield, MO, USA. METHODSEach surgery utilized the same femtosecond laser settings. Surgeries were performed with either a venturi or peristaltic vacuum system by a single surgeon (WJS). The EFX, percent power, ultrasound time (UST), the total time that the phaco tip was in the eye (phaco tip in/out time, PIOT) and the surgery time (speculum in/out time) were recorded. Exclusions and intraoperative complications were also analyzed. RESULTS995 eyes were included in the study. The EFX in the venturi eyes (1.7±1.3; n=521) compared to peristaltic eyes (2.1±1.4; n=474) was lower (p <0.0001). Similarly, the UST in the eyes performed with the venturi system versus the peristaltic system was reduced (32.4±22.3 sec vs. 40.7± 25.7 sec; p <0.0001). The PIOT in the venturi group compared to the peristaltic group was less (71.1±31.1 sec vs. 79.1±36.1 sec; p = 0.0002). The case time (speculum in/out time) was lower for the venturi eyes (307.2±68.8 sec vs. 311.6±53.6 sec; p=0.268). CONCLUSIONIn eyes undergoing routine laser cataract surgery, use of the venturi pump system was more efficient compared to peristaltic pump system based on energy use and time, and there was no significant difference in complications.