New phaco sleeve

Session Details

Session Title: Cataract Surgery Equipment/Instrumentation/Surgical Devices I

Session Date/Time: Monday 12/09/2016 | 14:00-15:30

Paper Time: 14:06

Venue: Hall C5

First Author: : T.Akahoshi JAPAN

Co Author(s): :                        

Abstract Details

Purpose:

To develop a new sleeve for micro coaxial phaco surgery. The advantages of the new sleeve should be (1) To avoid the thermal damage of incision from the heat of phaco tip (2) To provide sufficient irrigation and keep a deep and stable anterior chamber through a small sub-2mm incision (3) To attain good followability of the nuclear fragments at high flow rate setting for preventing the corneal endothelial cell damage (4) The movement of the tip in the tight incision should be smooth (5) To be easy to recognize and handle

Setting:

The clinical study was performed at the operating theater of Mitsui Memorial Hospital, Tokyo, Japan

Methods:

The sleeve is made of a thinner and stiffer silicone material to prevent twisting and collapsing. The surface is finished extremely smooth for easier movement. There are four ridges inside, running parallel to the shaft. Two ridges are placed 90 degrees to the large oval irrigation hole so that they can keep the phaco tip away from the upper and lower floor of the incision. The sleeve end is tapered to seal the forward flow to improve the fluidics in the anterior chamber. In another version, the third hole was created on the inferior side to increase the irrigation amount.

Results:

Attached on the off-centered square Harmonyx tip, there was no forward flow which pushes the nuclear fragments away. The irrigation flow from the third hole pushed the posterior capsule away from the tip. The anterior chamber was kept deep and stable. For the grade 2 nucleus, the aspiration time was 29.5±6.6 sec, BSS consumption 16.9±4.3 cc and CDE 2.6±0.8 (n=100) There was no thermal damage of the incision after the phacoemulsification of grade 4+ nucleus at 500 msec burst mode. As there was no mechanical or thermal damage, the incision was easily self-sealed.

Conclusions:

Thanks to the new material with thinner wall and larger irrigation holes, the amount of irrigation was increased even through a small micro coaxial incision. Tapered design improved the followability of the nuclear fragments. Sufficient irrigation realized safe and rapid removal of the nucleus with the minimum amount of the irrigation fluid. The unique four ridges inside the sleeve prevented the direct contact of the phaco tip to the sleeve wall and protected the incision from the thermal damage by the phaco tip. This sleeve is extremely useful for the phacoemulsification of very dense nucleus in MICS.

Financial Disclosure:

NONE