System fluidics enhance control

Chicago-A proprietary phaco platform (WhiteStar Signature, Abbott Medical Optics [AMO]) with transversal ultrasound technology (Ellips FX, AMO) has advanced cataract surgery to a new level of safety and efficiency. The "ramp" mode for aspiration and vacuum, the non-zero start with linear control of aspiration, and the newly introduced handpiece allow for safe surgery in an efficient manner, said Charles Ahn, MD.

"Once the fragment of the nucleus clears the tip, there is minimal to no surge afterward," said Dr. Ahn, in private practice, Downers Grove, IL, and assistant clinical professor of ophthalmology, University of Illinois, Chicago. "This increases the safety and is one of the advantages of this technology."

The ramp mode provides a balance between the aspiration and vacuum, he added. When the fragment reaches the tip and occlusion occurs, the pump automatically adjusts for that occlusion. As emulsification of the fragment continues and the tip clears, the machine adjusts for any surge that may occur.

The non-zero start with linear control of aspiration is another feature of the system on which he relies. It provides both efficiency and control of aspiration by allowing the surgeon to start at a fixed aspiration level with subsequent linear control with the foot pedal at aspiration beyond that threshold level.

The efficiency of the phaco system is tied to the new handpiece, the transversal ultrasound technology that was a recent addition to the system in 2010. The handpiece is the result of efforts to add to the longitudinal action of the phaco tip.

"The handpiece does a great job in merging longitudinal phacoemulsification with the nonlongitudinal ellipse mode to provide tremendous efficiency in emulsifying even the densest cataracts-much more so than when only longitudinal phaco is used," Dr. Ahn said. "There is no clogging of the tip with dense nuclei, which decreases or even eliminates the risk of a corneal wound burn."

In addition, combined with the advanced fluidics, the followability is increased with the handpiece, allowing the fragment to stay at the tip during emulsification.