Narrowing down on small incisions with 700-μm angulated phaco tip
Richard Packard, MD, explains how he created a phaco tip family to fill a need for a coaxial phaco tip that was efficient in small incisions.
By Richard Packard, MD, FRCS, FRCOphth, Special to Ophthalmology Times
London-Microincision cataract surgery (MICS) has become a standard procedure for cataract removal. The widely practiced biaxial and coaxial procedures allow for minimally invasive, sutureless surgery with fast wound healing and almost instant visual recovery.1,2
However, because microincisions provide a limited amount of room to insert and maneuver a phaco tip during lens removal, there has been an increasing demand for narrower phaco tips. These should allow for easier manipulation within the phaco wound, even with incisions of 1.8 mm.
MICS & MIGS:
In response to this demand, I developed a phaco tip (Packard 0.7 Phaco Tip, MicroSurgical Technology), that was intended particularly for coaxial MICS (CMICS). The instrument is part of a family tips with an outer diameter of 700 μm. These tips offer a narrower design than those generally used for MICS, which usually have an outer diameter of between 800 μm and 1 mm.
The Packard family of phaco tips is available in a wide assortment, bent at either 12° or 20° and offered in Dewey Radius, traditional, and reverse bevel versions. Although these phaco tips were designed initially for CMICS and bimanual MICS (BMICS), they also work very effectively with appropriate sleeves for incisions of up to 2.8 mm.
Related:
One of the most significant advantages of a narrow phaco tip is that it offers improved visibility of intraocular structures during surgery when compared with larger phaco tips.
Recent:
Particularly important with microincisions, a 700-μm phaco tip provides more room within the tunnel incision/sleeve for the surgeon to maneuver freely but also less restriction of irrigation fluid entering the eye.
Recent:
This should assist in maintaining the anterior chamber when high vacuum and aspiration flow rates are in use. The curved tip reduces the overall need to tilt it downward during surgery, which gives a more comfortable hand position-especially when operating temporally. This results in a reduced amount of wound stress and unintentional enlargement of the incision.
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