Efficiency of Radiused Tip in Phacoemulsification
Narrative Responses:
Purpose
To evaluate radiused and non-radiused phacoemulsification tips to determine which tip is more efficient in removal of lens fragments using three different ultrasound modalities.
Methods
Porcine lens nuclei were formalin-soaked for two hours or three hours and subsequently divided into 2mm cubes. 0.9mm, 30 degree bevel, radiused tips and non-radiused tips were used with torsional, transversal and micropulse ultrasound modalities. Bent tips were used for torsional ultrasound and straight tips were used for the transversal and micropulse ultrasound. Efficiency (time to lens removal) and chatter (number of lens fragment repulsions from the tip) were measured.
Results
Mean phacoemulsification efficiency was significantly decreased (increased time for removal) for the radiused tip with torsional ultrasound (2.14 +/- 1.94 vs. 1.18 +/- 0.69 sec; P < 0.05 for two hour soaked lenses and 5.07 +/- 4.2 sec vs. 2.52 +/- 1.99 sec P = 0.01 for three hour soaked lenses). There was no difference in efficiency with transversal and micropulse modalities between the radiused and non-radiused tips. There was no difference in chatter results with any of the three modalities between the radiused and non-radiused tips.
Conclusion
The radiused tip showed decreased efficiency with torsional ultrasound in our study; however, there was no difference in efficiency with transversal and micropulse technology. Our results suggest that a radiused tip may be used with some forms of phacoemulsification without loss of efficiency and the potential for greater safety.