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Bimanual phacoemulsification through 2 stab incisions. A wound-temperature study.
William Soscia1, James G Howard, Randall J Olson
1Department of Ophthalmology and Visual Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
Journal of Cataract and Refractive Surgery
|May 31, 2002
Summary
This study found that extremely high ultrasound energy levels are required to cause wound burns during bimanual phacoemulsification using a bare needle. These findings suggest that the Sovereign machine allows for safe performance of 2-stab ultrasound-based lens extraction in clinical settings.
Area of Science:
- Ophthalmology
- Surgical Technology
- Biomedical Engineering
Background:
- Cataract surgery often involves phacoemulsification to remove the lens.
- Ensuring thermal safety during phacoemulsification is crucial to prevent intraocular tissue damage.
- Bimanual phacoemulsification offers an alternative surgical approach.
Purpose of the Study:
- To investigate the thermal parameters associated with bimanual ultrasound-based phacoemulsification.
- To determine the energy levels and conditions that lead to wound burns using a bare aspiration needle.
- To assess the safety of the Sovereign phacoemulsification unit in a 2-stab incision technique.
Main Methods:
- In vitro laboratory study using human cadaver eyes.
- Employed the Sovereign phacoemulsification unit in three distinct modes.
- Utilized the Olson irrigating chopper in conjunction with a bare aspiration needle.
- Defined wound burn as exceeding 45°C, exhibiting whitening, or showing wound contraction.
Main Results:
- 100% ultrasound power was needed to induce wound burns in unoccluded continuous and burst modes.
- Time to burn induction varied: 160-180 seconds (continuous), 42-50 seconds (burst).
- Continuous ultrasound with occlusion required 80% power, with burn times of 58-70 seconds.
Conclusions:
- The energy required to cause a wound burn was exceptionally high.
- Thermal parameters for wound burns occurred well beyond typical clinical settings.
- The Sovereign machine facilitates safe 2-stab ultrasound-based lens extraction.