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Reducing ultrasound time can optimize Sovereign use
New software and hardware technology can additionally reduce ultrasound power in regard to phaco aspiration, one surgeon says.
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BOSTON - New technology and adopted occlusion mode provide a more effective chop technique, a more powerful aspiration of the nucleus and a more sensitive aspiration of epinucleus and residual cortical material, according to one surgeon.
Ekkehard Fabian, MD, of Rosenheim, Germany, and colleagues studied and changed the technique they used throughout the past 3 years. "Since 1997, we chose the shorter modulation possibilities and reduced the effective phaco time from 33 to 17 seconds," Dr. Fabian said during a presentation at the American Society of Cataract and Refractive Surgery.
The study
A prospective study was performed with three groups, with 20 patients in each group. All had cataract surgery with topical anesthesia and had phaco chop performed with the Sovereign phacoemulsifier (Allergan, Irvine, Calif.).
Patients in group 1 underwent phaco with the highest ultrasound power settings, with a flow of 20 mL/minute occluded and 18 mL/minute unoccluded, vacuum setting of 400 mm Hg and 30% to 40% ultrasound power. Patients in group 2 underwent phaco with a flow from 24 mL/minute occluded to 20 mL/minute unoccluded, vacuum setting at 420 mm Hg and ultrasound power of 10% to 15%. Patients in group 3 had the lowest settings in ultrasound power of 5% to 10%, flow from 20 mL/minute occluded to 14 mL/minute unoccluded and vacuum of 375 mm Hg.
Ultrasound power in groups 1 and 2 was 2%, and ultrasound power was 1.5% is group 3. Dr. Fabian said he found that there were no intraoperative problems, and the anterior chamber remained stable during the procedure for all three groups.
Advantages of the new technique
Besides the reduction of ultrasound time, Dr. Fabian reported other advantages of his new technique and the advantages of the Sovereign's technology. "Having the fluidics modulations, you can change between average settings. You have the possibility to protect the capsular bag."
He continued, "With these possibilities, you can adapt your settings for a soft or a hard nucleus, or you can change within the operation from one step to another, with respect to the technique you are using. The other point is if you use a zero ultrasound for setting four, you have the aspiration possibilities and the occlusion mode possibilities so that you can use the phaco tip for evacuating the capsular bag. You can also peel without any problems with respect to the capsular bag."
Furthermore, with the new technique and technology, Dr. Fabian said, "We have reduced trauma to the corneal endothelium."
For Your Information:
- Ekkehard Fabian, MD, can be reached at Agencentrum Rosenheim, 83022 Rosenheim, Germany; (49) 8031-389500; fax: (49) 8031-3895038; e-mail: augencentrum.rosenheim@t-online.de. Ocular Surgery News could not confirm whether or not Dr. Fabian has a direct financial interest in any of the products mentioned in this article or if he is a paid consultant for any companies mentioned.