Safest Phaco Tip for Prechopped Nucleus

Tuesday, April 21, 2015: 10:16 AM
Room 3 (San Diego Convention Center)
Takayuki Akahoshi, MD

Besides the efficiency, safety is another important requirement for a phaco tip. Now that the off-centered square wobble tip is established as the most efficient tip, a phaco tip with the maximal safety consideration was designed for the nucleus prechopped either by femtosecond laser or manual technique.

Completely smooth and round kissing lip shaped phaco tip was made and tested on the grade I and II prechopped nucleus with a Nano sleeve through a 1.8mm corneal incision using Centurion Vision System with the active fluidics at the flow rate of 60ml/min and vacuum at 700+mmHg. Aspiration time, BSS consumption, CDE, total operation time and corneal endothelial cell loss were recorded and analyzed.

Despite of the thick and round tip edge configuration, the followability of the nucleus was excellent thanks to the unique head design which blocks the forward irrigation flow to push the nucleus away from the tip. Prechopped nucleus was smoothly and quickly emulsified and aspirated. Average aspiration time was less than 30 seconds and CDE was less than 4.0. In more than 70% of the cases, the residual cortex was safely removed with the same phaco tip without exchanging to the I/A handpiece. There was no posterior capsule rupture in the first 100 consequent cases operated with this tip.

Kissing lip shaped tip is safe and fairly efficient for the prechopped nucleus. Current study was performed on the grade I and II nuclei, however if the nucleus was prechopped further into smaller pieces by the femtosecond laser, denser cataract can be possibly removed with this tip quite safely.