In vivo analysis of incision temperature of torsionally operated phaco probes having different stroke ratios between the probe distal end at the incisional region

Session Details

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

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

Paper Time: 14:12

Venue: Hall C5

First Author: : J.Zacharias CHILE

Co Author(s): :    N. Berthet                    

Abstract Details

Purpose:

To compare incisional temperatures in-vivo of the mini-flared tip and the balanced tip operated in torsional mode. The mini-flared tip has a distal lateral bend with an off-axis center of mass that produces lateral vibration of the shaft at the incision. Alternatively, the balanced tip has a distal bend with a balanced center of mass that noticeably reduces the lateral vibration of the shaft at the incision.

Setting:

Phaco-Dynamics Laboratory, Pasteur Ophthalmic Clinic, Santiago, Chile

Methods:

22 phacoemulsification procedures with nucleus graded LOCS II and III were performed using quadrant removal after phaco-chop. 11 eyes with the mini-flared tip and 11 eyes with the balanced tip. Aspiration rate was 30 cc/min, vacuum limit 350 mmHg and continuous torsional ultrasound. US-power was set to 60% for the mini-flared tip and to 40% for the balanced tip. Thermal imaging was recorded at 9 fps together with standard color video. The standard video recordings and the thermal recordings were time matched using a video editing software. Maximum temperature as well as temperature distribution patterns were analyzed and correlated.

Results:

The average peak temperature recordings were 35.4° ± 2.5° Celsius with the mini-flared tip and 29.6° ± 2.0° Celsius with the balanced. Baseline temperature = 26.2 ° Celsius. With both tips temperature increase was located in a small area coincident with the roof of the incision. This region could be visually correlated with the zone of compression between the tip sleeve and the corneal incision. Prolonged occlusions of the tip distal end by large nuclear fragments was associated with slowly rising temperature curves using both tips.

Conclusions:

Temperature rise using US power settings adjusted for stroke was lower for the balanced tip compared to the mini-flared tip. Surgical situations that produced incision-sleeve compression and tip occlusion showed the highest rise in incision temperature. The reduced lateral vibration of the shaft of the balanced tip at the incision can explain the reduced rise in incisional temperature with torsional operation.

Financial Disclosure:

NONE