Coaxial microincision surgery possible with phaco sleeve

Washington, DC-The combination of a new "ultra-sleeve" (Alcon Laboratories) with the Infiniti flare tip (Alcon) allows coaxial phacoemulsification to be performed with high efficiency through a 2.1-mm incision, said Richard J. Mackool, MD, at the annual meeting of the American Society of Cataract and Refractive Surgery.

Using the ultra-sleeve with the flare tip, surgeons can use flow rates between 40 and 50 ml/min and a vacuum level up to 400 mm Hg when the infusion bottle height is 135 cm. Values for flow and vacuum need to be reduced proportionately if the infusion bottle is lower.

With the introduction of the ultra-sleeve, surgeons seeking to minimize their cataract incision size now have an alternative to bimanual phacoemulsification performed through two microincisions. Considering the two approaches, Dr. Mackool believes use of the ultra-sleeve and flare tip to perform coaxial surgery through a single small incision offers advantages that will be appealing to most surgeons.

"Compared with use of the bimanual technique, the coaxial procedure allows for more rapid cataract removal because it can be performed with much higher flow and vacuum levels," Dr. Mackool said. "In addition, its use is associated with the smallest entry into the eye and surgeons who choose the coaxial approach can achieve its benefits without having to learn a new technique."