The Risk of Capsular Breakage from Phacoemulsification Needle Contact With the Lens Capsule: A Laboratory Study

Objective comparison of 4 nonlongitudinal ultrasound modalities regarding efficiency and chatter

“…Another concern is incision contracture (wound burns) secondary to heat buildup of the phaco tip and capsule breakage. Although we have shown that heat buildup is greater with Ozil, 8 as is the likelihood of breaking the capsule should it be contacted, than with Ellips, 9 we do not know how the increased motion and frequency of Ellips-FX might compare in both areas. This aspect should be studied.…”

“…Peripheral pieces are thrown away, and the remaining lens cubes are ready for testing. 9. Is Ellips-FX chatter at 100% power and 550 mm Hg vacuum and at 50% power and 300 mm Hg vacuum worse than Ellips chatter at the same settings?…”

The impact of tip bevel angulation on phacoemulsification efficiency and chatter

“…Bevel tip angulation has been speculated to influence the time to nuclear removal by influencing the amount of surface area available during cataract engagement. In addition, bevel tip angulation likely influences time to occlusion of tip and risk of capsular breakage, according to Meyer et al [1]. In a clinical setting and given a wide range of cataract nuclear densities, bevel tip angle impact has been difficult to gauge.…”

“…Therefore, bevel tip angulation and its impact on phaco are topics that have been discussed widely. Theoretically, different angles impact surface area available for cataract engagement, ultrasound modality choice, time to occlusion and risk of capsular breakage [1]. DeMill et al [2] and Oakey et al [3] have shown that even small adjustments in these parameters can lead to drastic changes in both efficiency and chatter during lens removal; however, evidence for bevel tip angulation and its impact on efficiency and chatter is lacking.…”

Safety Profile of Venturi Versus Peristaltic Phacoemulsification Pumps in Cataract Surgery Using a Capsular Surrogate for the Human Lens

“…One possible explanation is that unoccluded flow vacuum in peristaltic systems is greater than some might assume. 14,18,21,22 This would decrease the anticipated difference between the 2 systems in vacuum produced at the phacoemulsification tip, even without occlusion. It is difficult to explain why peristaltic vacuum might be worse.…”