Every ophthalmologist requires precise surgical tools with which he or she can perform surgery safely and accurately in order to ensure optimal outcomes. The availability of high-quality microsurgical instruments has increased over the past decade with manufacturers continually modifying and optimising existing instruments. Even small modifications to an instrument can lead to significant intraoperative and postoperative improvements.
There are a number of silicone I/A tip systems available. The silicone irrigation/aspiration (I/A) tip (Allegro) is a microsurgical instrument that allows the surgeon to safely remove cortical material during cataract surgery. It also allows the user to polish the posterior capsule, and rotate or adjust the placement of the IOL, which is particularly useful when implanting and positioning a toric IOL.
During cataract removal, the lens nucleus is hydrodissected and emulsified using ultrasound and, on occasion, assisted by a chopper or spatula which is inserted through a side port. After phacoemulsification of the lens is completed, an I/A system is used to aspirate the cortical material.
At the end of this procedure, it is possible for fragments of the lens nucleus or cortex to remain in the capsular bag. It is imperative that these fragments are completely eliminated since retained nuclear or cortical material may lead to severe inflammation, secondary glaucoma, and may also distort the IOL’s position.
Removing cortical fibers and fragments without damaging the delicate capsular bag is a fine art that requires not only skill and experience, but also an optimally designed I/A system.