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Torsional ultrasound could be ‘new standard’
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NUREMBERG, Germany — Torsional ultrasound has the potential to be the “new standard” in cataract surgery, Takayuki Akahoshi, MD, said. Surgical learning curves and minor modifications from standard phaco are really all that is needed, he said.
Torsional ultrasound is produced by a lateral movement of the phaco tip. Traditional longitudinal ultrasound moves back and forth within the eye, whereas torsional ultrasound oscillates back and forth. Torsional ultrasound also has a smaller incision and decreased risk of wound burn, according to Dr. Akahoski.
He described several adjustments he made to the phaco sleeve and tip to further increase aspiration times and enhance wound protection. He said he added a third hole to the side of the sleeve and was able to increase irrigation time to 120 mL per second, compared with the standard 88 mL per second in traditional ultrasound.
Alcon’s OZil handpiece has “the advantage of a torsional movement combined with the traditional longitudinal movement,” he told attendees at the German Ophthalmic Surgeons meeting here. Dr. Akahoshi said he recommends using the torsional setting for soft nucleus removal and using a combination of torsional and longitudinal movements for dense cataract removal.
Dr. Akahoshi added that he bends the tip downward to further protect the wound. “The tip [needs to be] almost parallel to the incision to prevent damage,” he said.