Combined occlusion-triggered longitudinal and torsional phacoemulsification during coaxial microincision cataract surgery: effect on 30-degree mini-flared tip behavior.

PURPOSE: To study the impact of a new power-delivery option using occlusion-triggered bursts of longitudinal phaco energy in addition to torsional tip movement in the performance of the 30-degree mini-flared tip to minimize tip clogging with dense nuclei.

SETTING: Prince Charles Eye Unit, King Edward VII Hospital, Windsor, United Kingdom.

DESIGN: Comparative case series.

METHOD: The cumulative dissipated energy (CDE) and time in foot pedal position 3 (FP3) to phacoemulsify each half of the nucleus with and without use of the new power-delivery option (Intelligent Phaco) were compared.

RESULTS: Fifty consecutive cataract operations were reviewed. The mean CDE was 1.79 with the new power-delivery option and 2.03 without the option (P=.08). For grades I, II, III, and IV nuclei, the corresponding values were 0.41 and 0.51 (P=.16), 1.43 and 1.23 (P=.31), 2.32 and 2.92 (P=.12), 3.82 and 5.03 (P=.005). The mean FP 3 time was 5.40 seconds with the new power-delivery option and 6.35 seconds without it (P=.03). For grades I, II, III, and IV nuclei, the corresponding values were 1.53 seconds and 1.98 seconds (P=.13), 4.47 seconds and 4.26 seconds (P=.69), 6.51 seconds and 8.77 seconds (P=.05), 11.81 seconds and 16.49 seconds (P=.008).

CONCLUSIONS: The new power-delivery option appeared to reduce the CDE and FP 3 time when a 30-degree mini-flared tip was used. The benefit accrued by preventing clogging of the needle was significant only in cases with a denser nucleus.