New phaco technology offers customizable features

Minneapolis-A new phacoemulsification system (Stellaris Vision Enhancement System, Bausch & Lomb) is state-of-the-art technology designed to meet the current and future needs of the contemporary phaco surgeon and surgical staff, according to Elizabeth A. Davis, MD.

Company engineers designed the system based on the input of existing customers, including 200 cataract surgeons and 40 ophthalmic nurses, who were queried to create a wish list for desired new features and changes to existing technology. The result is a machine that is compact, mobile, and extremely user-friendly, provides advanced fluidics and power modulation technology, and overall yields superior control and intraoperative efficiency.

Highly versatile, the system allows customizable preferences for vacuum or flow-based fluidics and supports standard small-incision coaxial phaco as well as microincision surgery using coaxial or bimanual modes. In addition, it was designed to be fully adaptable for future upgrades, eliminating the frustration of investing in new technology that too soon becomes outdated.

"The system performance was outstanding using both techniques, and what I found to be especially nice was that I could use this new phaco machine with essentially no learning curve for myself or my staff," Dr. Davis said. "The user interface was incredibly easy to navigate, and I was able to make a seamless transition to surgery with the [system]. It was a pleasure to be able to enjoy the enhancements and benefits of this advanced technology without having to make alterations in my technique."

Numerous features

The system features many innovations, including a redesigned, ergonomic, ultralight titanium handpiece with six instead of just four crystals. In addition, it offers an 18-inch, high-resolution, touchscreen display that is possibly the largest in the industry. The display uses a larger font size that is easy for the operating room staff to see from across the room. The display also allows the user the choice of different formats, features a streaming video inlay, and shows an animated guide providing complete set-up instructions.

The system's venturi pump is able to reach a vacuum level of 600 mm Hg. Dr. Davis said she performs a supracapsular flip technique and so favors using the advanced venturi pump that she couples with use of the company's high-resistance tubing to protect against postocclusion surge.

"The 600 mm Hg vacuum level greatly exceeds the maximum achievable using the [fluidics control] system [Millennium], and I found I could derive the benefits of the higher vacuum while maintaining solid chamber stability, even with a hard cataract. In two of three eyes I operated on using a 2.2-mm microcoaxial technique, I was also able to complete nucleus removal with aspiration only and no phaco energy," Dr. Davis said.

The system also has increased cassette capacity, 300 ml total, which reduces changing frequency, and there is an indicator on the console displaying the reservoir's level.

"That is a nice convenience factor for improving efficiency because the staff can judge if the reservoir is nearing capacity and change the cassette before starting a case, avoiding the need to interrupt midprocedure," Dr. Davis noted.

Addressing concerns over problems with the irrigation line falling off the handpiece, a new Luer-lock device has been added to ensure the tubing stays firmly attached.

"There is nothing more frustrating than having the chamber shallow because the irrigation line fell off the handpiece. By introducing the Luer-lock, the [company] engineers have come up with a very simple and effective solution to that problem," Dr. Davis said.