19 - Basic Principles of the Phacoemulsifier

Abstract

In 1967 Dr. Charles Kelman revolutionized cataract surgery when he developed and introduced phacoemulsification as an alternative to extracapsular cataract extraction. As a resident attending the Chicago Ophthalmological Society, I listened to Dr. Kelman stress the importance of the surgeon understanding the technology of his phacoemulsifier. Here we are, over one-half a century later, and we have tremendously advanced technology and instrumentation. Directed by the surgeon, current phacoemulsifiers perform remarkable maneuvers. Dr. Barry Seibel says that effective and safe phacoemulsification depends on the surgeon understanding the systems and the relationships between the systems that make up modern phacoemulsifiers. Most importantly, this knowledge allows the surgeon to optimize operative techniques for divide and conquer, stop and chop, horizontal and vertical chop, soft and hard cataracts, and so forth. In this chapter, I discuss the basics and relationships of these systems. For the surgeon to perform efficient cataract surgery and to decrease complications with difficult operations, this is essential knowledge.