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ZeroPhaco I/A handpiece enables lens fragmentation without ultrasound
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SAN DIEGO — A novel phacoemulsification handpiece lets surgeons perform lens fragmentation and removal without ultrasound in femtosecond laser-assisted cataract surgery, a speaker told colleagues here.
At the American Society of Cataract and Refractive Surgery meeting, P. Dee Stephenson, MD, FACS, described her clinical experience using the ZeroPhaco I/A handpiece (Bausch + Lomb) after femtosecond laser lens fragmentation.
P. Dee Stephenson
The ZeroPhaco I/A handpiece is preassembled with a microincision cataract surgery infusion sleeve. It is designed to be used with Bausch + Lomb’s Stellaris or Stellaris PC phacoemulsification platforms.
“We all look at the femto power and the phaco power, but what is the true power? I’m really worried about the collateral damage, if you will. … You want to balance the power and the energy,” Stephenson said. “The fluid that goes inside the eye is extremely important.”
Stephenson described how to convert femtosecond laser and phacoemulsification energy levels into joules.
Femtosecond laser power is normally 4 µJ to 7 µJ for capsulotomy and 7 µJ to 14 µJ, an average of 10 µJ, for fragmentation, Stephenson said.
“Effective phaco power for lens extraction, the [absolute phaco time] and [effective phaco time] vary depending on what phaco system is used,” Stephenson said.
Phacoemulsification power depends on the type of needle, proximity to the cornea, ultrasound frequency and cavitation bubbles, she said.
A femtosecond laser energy per pulse is normally 6,000 nJ, or 6 µJ. Pulse repetition rates are 80,000 pulses per second, or 0.48 J per second of lens fragmentation time. Active laser use is about 20 seconds, generating about 10 J.
A 20-second effective phacoemulsification time, multiplied by 40 MW, would yield 800 µJ, or 0.8 J total, Stephenson said.
The ZeroPhaco I/A handpiece is easy to use with a divide-and-conquer lens fragmentation technique, she said.
“You just kind of feed the cataract into the port of the I/A, and those little diced pieces just nicely go right into the port. So, it’s fairly easy to use this,” she said. – by Matt Hasson
Disclosure: Stephenson reports financial relationships with Bausch + Lomb, Lensar and i-Optics.