TY - JOUR
T1 - The Risk of Capsular Breakage from Phacoemulsification Needle Contact With the Lens Capsule
T2 - A Laboratory Study
AU - Meyer, Jay J.
AU - Kuo, Annie F.
AU - Olson, Randall J.
N1 - Funding Information:
Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc , New York, New York, to the Department of Ophthalmology and Visual Sciences, University of Utah, and by a Department of Ophthalmology and Visual Sciences Student Research Fund grant. Randall J. Olson is a consultant to Abbott Medical Optics. He has no other financial disclosures, now or in the previous 2 years, that relate to any commercial companies or devices; employee, other consultant or advisory positions; speaker bureaus, lecture fees; grant support, equity payments; patents; advisor to investment companies; and expert witness testimony. He has no financial involvement with companies that compete directly with products in this manuscript. He has no proprietary interest in any material or method mentioned. Involved in Design and conduct of the study (R.J.O., J.J.M., A.F.K.); Collection and management of the data (J.J.M., A.F.K.); Analysis and interpretation of the data (R.J.O., J.J.M., A.F.K.); and Preparation, review, or approval of the manuscript (R.J.O., J.J.M., A.F.K.). Human subjects were not involved in this study, so institutional review board approval was not necessary. No animals were used for this study, so animal care and use committee approval was not necessary. This study adhered to all United States and Utah laws.
PY - 2010/6
Y1 - 2010/6
N2 - Purpose: To determine capsular breakage risk from contact by phacoemulsification needles by machine and tip type. Design: Experimental laboratory investigation. Methods: Infiniti (Alcon, Inc.) with Intrepid cartridges and Signature (Abbott Medical Optics, Inc.) phacoemulsification machines were tested using 19- and 20-gauge sharp and rounded tips. Actual and unoccluded flow vacuum were determined at 550 mm Hg, bottle height of 75 cm, and machine-indicated flow rate of 60 mL/minute. Breakage from brief tip contact with a capsular surrogate and human cadaveric lenses was calculated. Results: Nineteen-gauge tips had more flow and less unoccluded flow vacuum than 20-gauge tips for both machines, with highest unoccluded flow vacuum in the Infiniti. The 19-gauge sharp tip was more likely than the 20-gauge sharp tip to cause surrogate breakage for Signature with micropulse and Ellips (Abbott Medical Optics, Inc.) ultrasound at 100% power. For Infiniti using OZil (Alcon, Inc.) ultrasound, 20-gauge sharp tips were more likely than 19-gauge sharp tips to break the membrane. For cadaveric lenses, using rounded 20-gauge tips at 100% power, breakage rates were micropulse (2.3%), Ellips (2.3%), OZil (5.3%). Breakage rates for sharp 20-gauge Ellips tips were higher than for rounded tips. Conclusions: Factors influencing capsular breakage may include active vacuum at the tip, flow rate, needle gauge, and sharpness. Nineteen-gauge sharp tips were more likely than 20-gauge tips to cause breakage in lower vacuum methods. For higher-vacuum methods, breakage is more likely with 20-gauge than with 19-gauge tips. Rounded-edge tips are less likely than sharp-edged tips to cause breakage.
AB - Purpose: To determine capsular breakage risk from contact by phacoemulsification needles by machine and tip type. Design: Experimental laboratory investigation. Methods: Infiniti (Alcon, Inc.) with Intrepid cartridges and Signature (Abbott Medical Optics, Inc.) phacoemulsification machines were tested using 19- and 20-gauge sharp and rounded tips. Actual and unoccluded flow vacuum were determined at 550 mm Hg, bottle height of 75 cm, and machine-indicated flow rate of 60 mL/minute. Breakage from brief tip contact with a capsular surrogate and human cadaveric lenses was calculated. Results: Nineteen-gauge tips had more flow and less unoccluded flow vacuum than 20-gauge tips for both machines, with highest unoccluded flow vacuum in the Infiniti. The 19-gauge sharp tip was more likely than the 20-gauge sharp tip to cause surrogate breakage for Signature with micropulse and Ellips (Abbott Medical Optics, Inc.) ultrasound at 100% power. For Infiniti using OZil (Alcon, Inc.) ultrasound, 20-gauge sharp tips were more likely than 19-gauge sharp tips to break the membrane. For cadaveric lenses, using rounded 20-gauge tips at 100% power, breakage rates were micropulse (2.3%), Ellips (2.3%), OZil (5.3%). Breakage rates for sharp 20-gauge Ellips tips were higher than for rounded tips. Conclusions: Factors influencing capsular breakage may include active vacuum at the tip, flow rate, needle gauge, and sharpness. Nineteen-gauge sharp tips were more likely than 20-gauge tips to cause breakage in lower vacuum methods. For higher-vacuum methods, breakage is more likely with 20-gauge than with 19-gauge tips. Rounded-edge tips are less likely than sharp-edged tips to cause breakage.
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U2 - 10.1016/j.ajo.2009.12.035
DO - 10.1016/j.ajo.2009.12.035
M3 - Article
C2 - 20231013
AN - SCOPUS:77952548757
VL - 149
SP - 882-886.e1
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
IS - 6
ER -