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A square phaco tip for dense cataracts
 The square Sidewinder/Power-Chisel phaco tip is helpful in dense cataracts. |
With a dense cataract, our goal is to minimize the phaco energy used in the case so that we can protect the corneal endothelial cells from damage. This can be accomplished in many ways: using a mechanical method to divide the nucleus (such as phaco chop), implementing phaco power modulations and using a fresh phaco tip.
The late Joel Shugar, MD, was an innovative surgeon who had another idea: Instead of using a standard, round phaco tip, he designed the Sidewinder/Power-Chisel tip, made by Mastel.
The Sidewinder tip is sharpened on both sides and has a special finish in order to be more efficient during phaco, particularly when combining longitudinal phaco with transverse/torsional ultrasound. I have found that this square phaco needle makes the dense cataracts far more manageable and allows the use of less phaco energy.
The first time I used this phaco needle, I was happy to see that the patient did not have significant corneal edema on the first postoperative day. The patient was happy because he went from 20/400 in the morning to 20/25 in the afternoon.