Fast-crack phaco technique may be easier than divide and conquer, surgeon contends

April 18, 2005

April 19 - Washington, DC - Fast-crack phacoemulsification is a very efficient ultrasound delivery system. The technique can be used for handling hard cataracts and used in eyes with narrow pupils, according to its proponent, Khiun Tjia, MD, who spoke during a symposium on phaco techniques during the American Society of Catartact and Refractive Surgery annual meeting.

Dr. Tjia, from Zwolle, The Netherlands, explained that the technique is "an upgrade to the divide-and-conquer technique, which is still widely used by cataract surgeons."

The disadvantages of the divide-and-conquer approach include time-consuming sculpting and a large amount of ultrasound energy, he noted.

With fast-crack phaco, the phaco tip is embedded fully to create a phaco groove and a hemi-crack. The surgeon impales the phaco tip in the lower half of the nucleus and a cracking instrument is placed underneath the phaco tip,

"With a simple movement, turning the instrument between your fingertips, you create a crack," Dr. Tjia said. "I will usually make three passes, then create the hemi-crack, and now simply continue digging."

Because there is no time-consuming sculpting, the total ultrasound operating time is reduced on average between 40 and 50 seconds, he explained.