Effect of Phaco Tip Diameter on Efficiency and Chatter

Sunday, April 27, 2014: 1:06 PM
Room 151A (Boston Convention and Exhibition Center)
Mohammed A. Farukhi SLC, UT, USA
Brian C. Stagg, MD, Moran Eye Center, Salt Lake City, UT, USA
Cecinio Ronquillo Jr., PhD, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
Kevin Kirk, University of Utah, Salt Lake City, UT, USA
Jason D. Jensen, University of Utah, Salt Lake City, UT, USA
Isha Gupta, University of Utah School of Medicine, Salt Lake City, UT, USA
William R. Barlow, MD, University of Utah, Salt Lake City, UT, USA
Jeff H. Pettey, MD, Moran Eye Center, Univeristy of Utah, Salt Lake City, UT, USA
Randall J. Olson, MD, Univ. of Utah, Dept of Ophth, Salt Lake City, UT, USA

Narrative Responses:

Purpose
To evaluate three phacoemulsification tips of different sizes and determine which tip size is most efficient in removal of lens fragments, using three different ultrasound approaches.

Methods
Porcine lens nuclei were formalin-soaked for two hours then divided into 2mm cubes. 1.1mm, 0.9mm and 0.7mm tips were used with Transversal and Micropulse ultrasound. 1.1mm tips were unavailable for Torsional ultrasound so 0.9mm and 0.7mm tips were used. Efficiency (time to lens removal) and chatter (number of lens fragment repulsions from the tip) were determined.

Results
Mean phacoemulsification efficiency was lowest for the 0.9mm tip for all three ultrasound variations. There were statistically significant differences between the 0.9mm and 0.7mm tip with Micropulse (0.8 +/- 0.29 vs. 1.4 +/- 0.93sec respectively; P = 0.0112) and Transversal (0.8 +/- 0.17 vs. 1.4 +/- 0.89sec respectively; P = 0.0065) ultrasound. There was no statistically significant difference between the 0.9mm and 0.7mm tip with Torsional or the 1.1mm and 0.9mm tips with Micropulse or Transversal ultrasound; however, trends were identical, with 0.9mm tips better than both 0.7 and 1.1mm tips.

Conclusion
In all three phaco systems the 0.9mm tip diameter was the most efficient, with the fewest outliers and smallest standard deviation when compared to other tip sizes. We expected the 1.1mm tip to be the most efficient; however, we found that the 0.9mm tip may be more efficient.