Effect of Phaco Tip With Large Bore Size on Ultrasound Energy in Eyes That Had Femtosecond Laser Nuclear Fragmentation
Narrative Responses:
Purpose
Many studies have demonstrated reduced EPT using optimized phaco tips and femtosecond laser lens softening, but there is little published information regarding the effect of phaco tip bore size on such softened lenses. This study attempts to answer the question, What is the effect of phaco tip diameter on EPT in FLACS?.
Methods
This prospective single-surgeon study evaluates 80 eyes separated into 4 study groups: no FLACS with small phaco tip, no FLACS with large phaco tip, FLACS with small phaco tip, FLACS with large phaco tip. The small tip is a 21 gauge (30 degree curved, 0.56mm Internal Diameter, 0.8mm Outer Diameter) whereas the large tip is a 20 gauge (30 degree bent,0.7mm Internal Diameter, 0.9mm Outer Diameter). The femtosecond laser groups received standard lens softening patterns and capsulotomy using the image guided Catalys laser system (Optimedica). All groups were limited to LOCS III Grade 2–4 cataracts and phacoemulsification settings were standardized using the WhiteStar Signature (Abbott Medical Optics).
Results
Average ultrasound power as well as Effective Phacoemulsification Time (EPT) showed a decrease when using either a larger bore phaco tip (20 guage versus 21 guage) or with the use of femtosecond laser assisted cataract surgery compared to traditional phacoemulsification alone. However the reduction in both average ultrasound power as well as Effective Phacoemulsification Time (EPT) was most significant when combing the use of larger bore phaco tip size with femtosecond laser–assisted cataract surgery.
Conclusion
Optimization of phaco tip size when performing femtosecond laser–assisted cataract surgery may result in greater reduction of phacoemulsification energy.