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Phaco technology makes the surgeon's job easier


Lisbon, Portugal—Two new innovations in cataract surgery should improve the efficiency for the surgeon and the outcome for the patient, reported Steven Dewey, MD.

The new WhiteStar ICE (Increased Control and Efficiency) Technology (Advanced Medical Optics Inc. [AMO], Santa Ana, CA) used during phacoemulsification is making the surgeon's job easier by providing increased surgical control of the anterior chamber environment and maximizing the efficiency of ultrasound. The system can be used effectively with all cataract densities. Dr. Dewey reported on the first patients to undergo cataract surgery using the new power control modality to colleagues at the European Society of Cataract and Refractive Surgeons meeting in Lisbon and will give a presentation at the American Academy of Ophthalmology meeting in Chicago this month.

"ICE Pulse shaping is designed to increase the efficiency of ultrasonic energy in the eye by maximizing cavitation. The system improves the cutting efficiency, keeps energy in the eye low, and retains the magnetic followability of WhiteStar Technology. Absolutely no change is required in the surgeon's technique," he said.

"This variability provides linear control not only of power but also of duty cycles. Ultimately, the surgeon has complete discretion in tailoring the system to his or her needs," he said.

A component of the system is WhiteStar Technology CASE (Chamber Stabilization Environment), which provides automatic control and monitoring of the vacuum. This feature reduces vacuum when occlusion occurs after maintaining particle holding power and resets the maximum vacuum when occlusion clears.

"The system, in essence, anticipates the potential for chamber surge and reduces the vacuum before the occlusion breaks," Dr. Dewey explained.

The second innovation is a smooth, rounded phaco tip design developed by Dr. Dewey to improve the safety of the procedure, regardless of the equipment manufacturer. He demonstrated the standard sharp edge, which appeared rough. The challenge, he explained, is the need to dispel the longstanding myths that sharp edges are necessary to cut nuclear material, and that the capsule will break with vacuum alone. The patent-pending smooth phaco tip design, he emphasized, improves safety for the capsule, the iris, and the incision.

On a 1 to 4 scale of nuclear sclerosis, 39 of the 45 patients had a 2+ cataract. The mean FPT was 0.69 ± 0.32 minute, the mean % power 2.31% ± 1.60%, and the mean EPT 1.10 ± 0.91 seconds. In six patients with a 3+ cataract, the respective figures were 1.61 ± 0.47 minutes, 3.90% ± 1%, and 4 ± 1.80 seconds.

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