Effect of phaco tip diameter on efficiency and chatter

Abstract

To evaluate 3 phacoemulsification tips of different sizes and determine which size is most efficient in lens fragment removal using 3 ultrasound (US) approaches. John A. Moran Eye Center Laboratories, University of Utah, Salt Lake City, Utah, USA. Experimental study. Porcine lens nuclei were formalin-soaked for 2hours then divided into 2.0mm cubes; 1.1mm, 0.9mm, and 0.7mm phaco tips were used with torsional and micropulsed US. The 1.1mm tips were unavailable for torsional US, so 0.9mm and 0.7mm tips were used. Efficiency (amount of time for lens removal) and chatter (number of lens-fragment repulsions from the tip) were determined. The mean phacoemulsification efficiency was highest with the 0.9mm tip for all US variations. There were statistically significant differences between the 0.9mm and 0.7mm tips with micropulsed US (0.8 seconds±0.29 [SD] versus 1.4±0.93seconds; P=.0112) and transversal US (0.8±0.17seconds versus 1.4±0.89seconds; P=.0065). There was no significant difference between 0.9mm and 0.7mm tips with torsional US or between the 1.1mm and 0.9mm tips with micropulsed or transversal US; however, trends were identical, with 0.9mm tips performing better than 0.7mm and 1.1mm tips. With all 3 systems, the 0.9mm tip was most efficient, with the fewest outliers and smallest standard deviation. No author has a financial or proprietary interest in any material or method mentioned.