Phaco tips and tricks pdf

Less energy delivered to the eye thus reducing side effects 38. A very small no stitch incision is made in the side of the cornea. Tips and tricks for teachers educating on zoom april 2020 2 teaching over video delivery tips and tricks preset your meeting to mute participants microphones upon entry. Zoom, a popular social platform, has experienced a. Complete nuclear disassembly of superhard cataracts cannot always be achieved by phaco chop, which is considered one of the best techniques for. The phacotips are delivered inclusively with a reusable plastic key. Practical tips for young ophthalmologists eurotimes. The top countries of suppliers are china, india, and pakistan, from which the percentage of phaco tips supply is 55%, 23%, and 20% respectively. Current phaco tips are available with12 or 20 bends. Mastering techniques, optimizing technology, and avoiding complicationscovers everything from stepbystep instruction for the beginner to advanced chopping for complicated cases or bimanual phaco. As the first text completely devoted to this popular topic, it is equally.

Such an incision promotes fast and more comfortable recovery 2. Chemical and physical analysis of phaco handpiece tip. This analysis is based on basic mathematical and physical science and is also supported by experimental investigations to verify that the physical models are accurate. May 18, 2014 maximum phaco power maximum obtainable ultrasonic energy when foot pedal control is fully depressed actual phaco power power actually delivered at a given time proportional to foot pedal position. Place the sharply angled tip of the blade at the very center of the nucleus. Phacoemulsification phacoemulsification was invented and developed by dr. Apr 03, 2019 low flow, low vacuum, and low phaco power are used. The phaco probe tip is partly aligned a sideways towards. Understanding phacoemulsification iii principles of nucleofractis techniques. By impaling the blade at this location, the stress on the zonules is equalized and minimized. I have experimented with thick, thin, square, singlebeveled, doublebeveled, and flared ones and even some that looked like a chisel. Effective phaco time total phaco time at 100% phaco power.

Full text a rapid technique for en masse soft cataract. Step by step phacoemulsification tips and tricks pdf. Discussing cracking techniques, dr ribeiro said the best technique. No products are being displayed product is being displayed products are being displayed. Phacoemulsification department of ophthalmology academic. While phacoemulsification is no longer the latest technology, it is the standard procedure for removing cataracts providing the ophthalmic surgeon with practical advice for developing surgical skill in the area, vikas mahatme reveals his tips and tricks for performing phaco and overcoming the complications that can be encountered on a daily basis. This completely revised and updated resource contains a detailed description of the basic technique of phacoemulsification and the special techniques devised by dr. The fsonic phaco tip marks the next step in the evolution of high precision tools to perform small and microincision cataract surgery. The amo whitestar signature, with the transversal tip, is the originator of the phaco power modulations, said dr. Enter a word or two above and youll get back a bunch of portmanteaux created by jamming together words that are conceptually related to your inputs. Tips with 60, 45, 30, 15 and 0 angulation are available. Phaco power you want to use only an amount of energy that you need. Intelligent phaco initially, there was an issue with ozil where sometimes with harder cataracts a fragment could clog the tip particularly with flared tips. Phaco tips can be classified according to caliber, tip angle, bevel position, bevel angle, and shape of the distal end.

And so generally if you have a fixed phaco, i would say 30%, 40% phaco is a reasonable place to start. Initially the offcentered tip was designed for the alcon ozil torsional us handpiece alcon, fort worth, texas, dr. In addition, the roughness of the opening in all tips was assessed through 3dimensional whitelight interferometry. The bag of the lens is opened and the ultrasonic probe phacoemulsifier removes the cloudy lens. To remedy this, intelligent phaco ip was introduced on the infiniti, and it is still available on the centurion. A 2step incision will be made for dense nuclei or eyes at risk for iris prolapse because of. Medicel phaco tips, sleeves and complementary accessories are compatible with most phaco machines on the market. In 2010, ophthalmologists find themselves weighing the benefits of newer technologiesincluding torsional and transversal phaco machinesover their traditional longitudinal devices. Basic principles of phacoemulsification and fluid dynamics. Along with the high fluidics that are provided with this platform and made possible with the easytip, this means that i. If you are using a machine that is a few years old, you owe it to yourself to test drive the newer models. Learn how to market your practice to patients through materials based on patient insights. Step by step phaco tips and tricks download pdf bkozoxiydtk.

Mar 31, 2012 new phaco tips are the key to surgical efficiency these tips ensure a technique that is highly reproducible, uses a minimal number of instruments and steps, and flows smoothly with no mental stress. A wide variety of phaco tips options are available to you, there are 43 suppliers who sells phaco tips on, mainly located in asia. In the first stages of a cataract, people may notice only a slight cloudiness as it affects only a small part of the lens, the part of the eye that focuses light on the retina. For a soft cataract, a single plane keratome incision is made. Phaco needle tips can have various configurations with respect to angle of the tip straight vs angled or kelman, size of the lumen, shape of the lumen round, ellipsoid, bent, or flared, and bevel angle 0, 15, 30, 45, or 60.

Mar 31, 2012 the four key characteristics of phaco tips that impact the efficiency and safety of the phaco procedure are. Hoffman, md despite its unparalleled success in the field of surgery, the precise mechanism of ultrasonic phacoemulsification cataract extraction remains controversial. These 2 instruments and techniques are suitable for the entire spectrum of cataracts. For surgeons who use a divide and conquer or chopping technique, he recommends a straight or. Phaco tips, bubble free, ultrasonic phaco tip at sun coast. The phaco tips were examined through energydispersive xray spectroscopy eds and xray photoelectron spectroscopy xps for elemental composition. To answer surgeons procedural needs, he says microsurgical technology is developing tip designs with attributes that can be used for a variety of phaco techniques chop procedures or divide and conquer as well as unique tips for bimanual phaco, or.

It can have an opening angulation of 0,15,30, and 45. Outflow is defined by vacuum, aspiration, tubing size, around your tip at the time. Nov 04, 2016 so theres phaco power, theres vacuum, and then theres irrigation. Within this book the determinants of phacoemulsification machine fluidics are examined and analysed. Aug 17, 2019 for the phaco probe it is important to have a sufficient amount of metal showing from the phaco needle to bury the tip into the cataract nucleus and have enough holding power to perform the phaco chop. Cataract offcentered phaco tip design by ellen stodola eyeworld staff writer two views of the harmonyx phaco tip. The latest fsonic phaco tip set improve holdability and followability, and further reduce corneal wound stress. Sep 15, 2003 phaco tips can be designed with elements to help control postocclusionbreak surge, he says.

His objective was to perform the ecce through a small incision. Fishkind, md, facs phaco tips, we are always looking for a better one. Mar 21, 2011 a surgeon might use phaco 1 for sculpting, phaco 2 for cracking and phaco 3 for quadrant removal, mr. Phaco tips, we are always looking for a better one. Phacoemulsification is a modern cataract surgery method in which the eyes internal lens is emulsified with an ultrasonic handpiece and aspirated from the eye. It is just a quick guide and does not replace careful haagstreit ag, koeniz, switzerland reading of the instruction for use of the software. Product list to phaco tips and sets back to the overview. Understanding the phaco machine is vital to a successful surgery. This micro amount of energy does not heat up the phaco needle, and all three devices can deliver this type of energy, he said.

The tip s edge geometry and finishing might be important to improve lens fragmentation. Excellence at your finger tips there are several high end phaco designs available in the market today. This helps to avoid background noise and allow your students to focus on your lesson. Commonly used fragmentation techniques of phacoemulsification for soft. The phaco probe is an ultrasonic handpiece with a titanium or steel needle. I prefer largebore phaco needles for dense cataracts, because they allow for more efficient phaco aspiration of the nuclear material.

Ashley thomas jacob ms dnb mrcophth high end phaco. Phacoemulsification for cataracts procedure, recovery. The movement of the foot pedal is of paramount importance and you should practice the positions of the foot pedal i. Aspirated fluids are replaced with irrigation of balanced salt solution to maintain the anterior chamber. Any phaco tip can be used given the proper parameters, which differ according to the characteristics of the tip. These can be based on peristaltic or a venturi type of pump. Aug 01, 2017 to our knowledge, only 1 recently published 2part experimental study analyzed the chemical properties of new and resterilized phaco tips. Principles and techniques, second edition is perfect for the surgeon interested in learning the concepts, developing skills, and preparing for the actual surgical procedure. The phaco time can be decreased by applying the ultrasonic power only when cataract pieces are at the phaco tip and vacuum alone is insufficient to aspirate the piece. To help avoid surge, the system uses an antisurge system built into the software that controls the ramp up and ramp down of the peristaltic pump. By necessitating increased phaco power and time, the potential for wound burn and endothelial cell loss is increased. The last section explores a topic that is generating growing interest bimanual phaco. Greater angulation facilitates sculpting whereas lower angle is good for occlusion. Amo originally called it cold phaco because it wouldnt build up heat.

Whitestar signature pro phacoemulsification system. Capsulorrhexis can be performed with bent 26 or 27 g needle or. Phacoemulsification is a technique which employs the ultrasound energy and fluid dynamics to facilitate the removal of nucleus and cortex of the lens in the cataract surgery. In longitudinal phaco, the needle tip uses an inandout motion to break up the lens material, noted steven i. Pdf use of the phaco tip technique for lens cleavage and removal. It is just a quick guide and does not replace careful haagstreit ag, koeniz, switzerland reading of the instruction for use of. The configuration of the phaco tip used in cataract surgery is based on surgeon preference.

Additionally, phaco time can be reduced by delivering shorter pulses or bursts of phaco power instead of continuous ultrasound power or by decreasing the duty cycle the ratio of. They may incorporate an aspiration bypass system to decrease surge. Nov 28, 2014 phaco tip the phaco tip is made of titanium and is hollow with the distal opening functioning as the aspiration port. Sep 01, 2016 seven types of phacoemulsification tips were studied. Phaco tips phaco tips you can use the following products with the whitestar signature system, the sovereign and the sovereign compact system. Pdf video conferencing has become more important than ever, particularly during the coronavirus pandemic. Ideally combined with our phaco handpieces the tips provide an optimal ultrasound efficiency and grant a good irrigationaspiration balance. Top 5 tips and tricks to get the most out of your surface. Compatible with our phaco handpieces we offer reusable phacotips made of titanium. Sun coast medical offers costeffective phaco tips for use with most machines including alcon, storz, amo, oms, and mentor.

Look at the camera to create eye contact with your students. The conical plus phaco tip the alternative solution for the alcon legacy features. I have ventured to analyze only those that offer some value and uniqueness that would help the individual surgeon in bettering his technique and. Deweys idea was to increase the safety of phaco during cataract removal. I work in occlusion, and i use the venturi pump to provide high vacuum. Learning how to safely perform phacoemulsification is one of the key surgical techniques for an ophthalmologist. Techniques of phacoemulsification surgery, fourth edition pdf cdrom is the. Although many studies of phacoemulsification techniques have been published, much less is published about the hardware tips used in the procedure. The tip of the needle vibrates at ultrasonic frequency to sculpt and emulsify the cataract while the. The stellaris pc vision enhancement is capable of 1.

Giving an expert overview of phacoemulsification during this session. The more brunescent and sizable a mature nucleus is, the greater the risk of complications. A scleral tunnel that is too long may constrict the irrigation sleeve, and so the corneal tunnel length should be restricted to less than 1. Cataract surgery by phacoemulsification is the standard of care today and there are a. Phacoemulsification surgery involves the use of a machine with microprocessorcontrolled fluid dynamics. Surgical techniques for horizontal and vertical phaco chopping. Chop settings have much higher vacuum to provide holding power on the nucleus so that the phaco chop technique can be used.

Takayuki akahoshi, md, tokyo, discussed several phaco tips he has designed over the years and why there was a need for different bent, offcentered, straight, and square tips. Phacoemulsification, or phaco, as surgeons refer to it, is used to restore vision in patients whose vision has become cloudy from cataracts. The dewey radius phaco tips were designed from the inspiration of steve dewey md. Sculpt is the setting used to create a groove or trench, using low flow, low vacuum and moderate phaco power, for techniques such as divideandconquer or stopandchop. These options are relevant for any phaco surgeon, regardless of technique or experience. The 12 tip is favored by surgeons who are used to straight tips, but it has approximately 30% less tip end movement than the 20 bend tip. I prefer largebore phaco needles for dense cataracts, because they allow for more efficient phaco aspiration of the. Comparison of different types of phacoemulsification tips. A guide to phacoemulsification all india ophthalmological society. Proper positioning of the chopper and phaco tips relies more on tactile rather than visual clues. This is a promising and advanced application that combines phaco chop with the latest innovations in microincisional phaco technology. All chopping techniques utilize manual instru ment forces to segment the.

Positioning of instrument tips at inadequate depth can lead to poor delivery of cracking force, and potentially push the posterior plate closer together red arrows. Reducing the tip diameter andor tip wall thickness also augments phaco tip cutting edge displacement. Akahoshi, the harmonyx tip provides for a safer and more efficient procedure. Progressive cracking technique for phacoemulsification of. The system also allows 24 different users to save their mode settings. Miniflared kelman tip, reverse tip, and sidewinder tip with. The acoustic energy produced along the ultrasonic handpiece is then transmitted onto the phaco tip. Feb 02, 2021 the beginning phaco surgeon has a tendency to ride the phaco pedal too long, so be sure to return to irrigation only when the phaco tip is not engaged in lens material. In most phacoemulsification techniques, ultrasound energy is directed at the corneal endothelium ce because of the bevelup tip position.