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Pointing irrigation tip downward can help protect the endothelium in phaco
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GOIANIA, Brazil — Protecting the delicate endothelium is one of the cataract surgeon's main priorities in a phacoemulsification procedure, a surgeon said here at the International Congress of Cataract and Refractive Surgery.
"When surgeons point the irrigation tip upwards during cataract surgery, there is a lot of turbulence in the capsular bag toward the tip entrance point and toward the endothelium," Marcelo Ventura, MD, of Brazil, said. This turbulence can cause damage to the endothelium.
Dr. Ventura said that it is common for the surgeon to adjust the irrigation sleeve horizontally, which may cause the irrigation to hit the endothelium directly.
One of the problems with the curved tip is that although the surgeon starts out using it horizontally, he said, during the procedure the tip might end up being inadvertently pointed toward the cornea, which can cause the endothelium considerable trauma.
"Simply inverting the direction of the tip downward can reduce the turbulence considerably and prevent the damage caused by the nucleus pieces touching the endothelium," he said.