Posters

Double-edged prechopper

Poster Details

First Author: T.Akahoshi JAPAN

Co Author(s):                        

Abstract Details

Purpose:

Phaco Prechop is a procedure to chop the nucleus prior to the phacoemulsification. Conventionally two methods with two different prechoppers were used according to the nuclear density. The purpose of this study is to develop a new prechopper which satisfies the following requirements as an ideal prechopper: (1) Easy to master the manipulation (2) Smooth insertion with less stress on the ciliary zonule (3) Easy to attain the complete separation of the nuclear fragments (4) Easy to rotate the nucleus (5) Safe (6) Applicable to broader range of the nuclear density (7) Durable (8) High cost performance

Setting:

Prototypes were produced by the courtesy of ASICO. Clinical evaluation was performed at the operating theater of Nihonbashi Cataract Clinic and Akihabara Eye Clinic in Tokyo, Japan in more than 3,000 cataract cases.

Methods:

The conventional Combo Prechopper had a sharp edge only on the straight side of the blade, while rounded side was blunt. It was used only in the vertical Karate Prechop technique for soft nuclei. The new prechopper has sharp edge not only on the straight side but also at the tip of the rounded side. Accordingly the blade tip has a very sharp edge, which can be used also for Counter Prechop technique. The blade height was increased to broaden the surface area to enhance the ability of nuclear separation. The blade thickness was reduced as thin as possible.

Results:

Thanks to the extremely thin blades, insertion was much easier even into the nucleus of medium hardness which was difficult to prechop with the conventional Combo Prechopper by Karate Prechop technique. Very soft cataract, which was difficult to prechop because the blades couldn’t provide enough separating force, could be easily divided thanks to the broader blade surface. By providing the counter force with the nucleus sustainer, denser cataract such as grade 3+ could be prechopped. Thus grade 1 to 3+ nuclei could be managed successfully with this new prechopper by either Karate or Counter Prechop technique.

Conclusions:

The new double edged prechopper extended the indication of prechop from grade 1 to 3+. Single instrument can be used both in the vertical Karate Prechop for soft nuclei as well as the horizontal Counter Prechop for dense nuclei. It satisfies all the requirements from (1) to (8) as an ideal prechopping device. Without using very expensive and time consuming femtosecond laser, this single prechopper will manage the nuclear fragmentation of broader range of nuclear density much more easily and efficiently. It will enhance the safety and efficiency of the modern cataract surgery with minimum cost and learning curve.

Financial Disclosure:

None