Flared phacoemulsification tips to decrease ultrasound time and energy in cataract surgery

To determine the effect on ultrasound (US) time and energy of using flared phacoemulsification tips in cataract surgery.

Private referral practice of Pacific Cataract & Laser Institute, Chehalis, Washington, USA.

One surgeon using the Allergan Medical Optics Diplomate phacoemulsification machine performed cataract surgery by a single divide-and-conquer technique. A prospective nonmasked consecutive study group (n = 262) was selected from patients operated on with phaco tips flared by 25%. A consecutive control group (n = 440) was selected from patients having surgery using the same technique except for the use of straight phaco tips. The study group had cataract surgery over a 5 week period and the control group, over an earlier 10 week period. Two weeks separated the groups. Cases complicated by vitreous loss were eliminated. The 2 groups were compared by age, sex, total phaco time (TPT, the total time ultrasound energy was applied), and equivalent phaco time (EPT, the product of the phaco time elapsed and the phaco energy).

One patient in each group was eliminated for vitreous loss during surgery. There were no significant differences in age, sex, or eye between the 2 groups. The study group had a mean TPT of 29.2 seconds +/- 11.7 (SD) (range 0 to 88 seconds) and a mean EPT of 16.4 +/- 8.6 seconds (range 0 to 67 seconds). The control group had a mean TPT of 34.4 +/- 16.1 seconds (range 0 to 130 seconds) (P <.001) and a mean EPT of 20.0 +/- 12.8 seconds (range 0 to 107 seconds) (P <.001).

Flared ultrasonic phacoemulsification tips significantly reduced the US time and energy used in cataract surgery.