Balanced tip design minimizes need for longitudinal energy

Take-home message: Though there is a short learning curve for performing a direct phaco chop technique with a 45° balanced tip, it makes surgery more efficient by eliminating or minimizing the need for longitudinal energy.

Reviewed by Ramón Ruiz-Mesa, MD

Jerez de la Frontera, Spain-Phacoemulsification using a chop technique and a proprietary phacoemulsification platform featuring torsional energy (Centurion Vision System, Alcon Laboratories) can be performed effectively and efficiently using a 45° balanced tip, said Ramón Ruiz-Mesa, MD.

The 45° balanced tip (45° Intrepid Balanced Tip, Alcon) was introduced with the Centurion platform and features a straight shaft with two opposite bends along its axis.

Dr. Ruiz-Mesa, medical director, Clinica Oftalvist CIO, Jerez de la Frontera, Spain, undertook a study comparing the 45° balanced tip with the 45° mini-flared Kelman tip (Alcon) to investigate his clinical impression that phaco chop was more difficult after he switched from operating with the 45° mini-flared tip with the Infiniti Vision System (Alcon) to the Centurion platform with the balanced tip.

The results showed otherwise.

“In a formal comparison of the two tips using the Centurion platform, we found there was only a short-learning curve for performing phaco chop using the balanced tip,” Dr. Ruiz-Mesa said.

In addition, although the results remained excellent using the mini-flared tip, phacoemulsification with the Centurion platform was actually more efficient using the balanced tip as it particularly saved energy by reducing the need for longitudinal ultrasound in denser cataracts, he said.

“This is important because compared with torsional energy, longitudinal energy is more thermogenic and so has more potential for causing harm to the endothelium,” Dr. Ruiz-Mesa said.

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