Comparison of Off-Centered Phaco Tips
Narrative Responses:
Purpose
The tip head configuration and cutting edge length of the tip port should play important roles in the efficiency of the torsional phaco. To find out the most suitable phaco tip for the torsional phaco, off-centered phaco tips of four different shapes were made and tested.
Methods
Off-centered flared phaco tips with round, oval, square and rectangular design with 12 degree reverse bent bevel were made and tested with a Nano sleeve. The grade II nucleus was prechopped into four pieces and phacoemulsified by custom pulse mode at 150 msec torsional on time. The CDE, aspiration time, BSS consumption and corneal endothelial cell loss were analyzed statistically.
Results
The CDE was round 3.41 > oval 2.27 > square 2.15 > rectangular 1.98. The oval, square and rectangular tips were superior to the round tip statistically. The aspiration time was oval 44.4 > rectangular 44.2 > round 41.5 > square 33.2 sec. The square tip was superior to other tips in aspiration time and BSS consumption as well. There was no difference in the endothelial cell loss. Due to the oblong configuration of the tip head in oval and rectangular tips, the forward flow between the tip head and sleeve obstructed the followability of the nuclear fragment.
Conclusion
The rectangular tip with flat surface and long cutting edge attained the best efficiency, however the aspiration time was extended due to the poor followability of the nuclear fragment with the conventional sleeve. With some improvement in the sleeve design, it can be the best tip for the torsional phaco.