One-Handed Rotational Phacoemulsification Technique
Received 16 September 2020
Accepted for publication 23 November 2020
Published 5 February 2021 Volume 2021:15 Pages 431—435
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Samuele Gigliola,1 Giancarlo Sborgia,1 Alfredo Niro,2 Carmela Palmisano,1 Pasquale Puzo,1 Gianluigi Giuliani,1 Luigi Sborgia,1 Valentina Pastore,1 Alessandra Sborgia,2 Giovanni Alessio1
1Eye Clinic, Depatment of Medical Science, Neuroscience and Sense Organs, University of Bari, Bari, Italy; 2Eye Clinic, Hospital “S. G. MOSCATI”, ASL TA, Taranto, Italy
Correspondence: Alfredo Niro
Eye Clinic, Hospital “S. G. MOSCATI,” ASL TA, Via per Martina Franca, Statte, Taranto, 74010, Italy
Introduction: We described a one-handed rotational phacoemulsification technique to decrease phaco time and power, and surgical stress on the cornea in eyes with different types of cataract.
Methods: In this technique a single sutureless corneal incision was made without any side-port incision. After hydrodissection and hydrodelamination were performed, a phaco tip was positioned in contact with the nucleus beside the capsulorhexis edge. By using a peristaltic pump, phacoemulsification was started with high levels of vacuum to keep the probe tip on the edge of the lens and to ensure the rotation of the nucleus, and with low ultrasound energy. The torsional mode used required less occlusion time and volume of fluid. The inclination of the tip was modified to 45-degree, directing it toward the lens center. So the nucleus was aspirated from the periphery toward the center by a rotational movement.
Results: The eye in the technical video had a NC4-NO4 cataract. The preoperative vision in this eye was 20/100 with no improvement with refraction. On postoperative day 1, visual acuity had improved to 20/20. We recorded low intraoperative parameters including ultrasound time (21.4 sec), phacoemulsification power (73%), balanced salt solution used (31 mL) and cumulative dissipated energy (7.27) at the conclusion of the case. After 1 month, Central Corneal Thickness changed from 504 μm to 516 μm, and Endothelial Cell Loss was 1.15%.
Conclusion: This technique uses a single clear corneal incision, high vacuum and low ultrasound power to reduce the exposition to excessive surgical maneuvers, fluid turbulence and ultrasound energy.
Keywords: cataract surgery, single corneal incision, one-handed phacoemulsification, phaco-rolling
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