Combined occlusion-triggered longitudinal and torsional phacoemulsification during coaxial microincision cataract surgery: Effect on 30-degree mini-flared tip behavior

PurposeTo study the impact of a new power-delivery option using occlusion-triggered bursts of longitudinal phaco energy in addition to torsional tip movement in the performance of the 30-degree mini-flared tip to minimize tip clogging with dense nuclei.SettingPrince Charles Eye Unit, King Edward VII Hospital, Windsor, United Kingdom.DesignComparative case series.MethodThe cumulative dissipated energy (CDE) and time in foot pedal position 3 (FP3) to phacoemulsify each half of the nucleus with and without use of the new power-delivery option (Intelligent Phaco) were compared.ResultsFifty consecutive cataract operations were reviewed. The mean CDE was 1.79 with the new power-delivery option and 2.03 without the option (P = .08). For grades I, II, III, and IV nuclei, the corresponding values were 0.41 and 0.51 (P = .16), 1.43 and 1.23 (P = .31), 2.32 and 2.92 (P = .12), 3.82 and 5.03 (P = .005). The mean FP 3 time was 5.40 seconds with the new power-delivery option and 6.35 seconds without it (P = .03). For grades I, II, III, and IV nuclei, the corresponding values were 1.53 seconds and 1.98 seconds (P = .13), 4.47 seconds and 4.26 seconds (P = .69), 6.51 seconds and 8.77 seconds (P = .05), 11.81 seconds and 16.49 seconds (P = .008).ConclusionsThe new power-delivery option appeared to reduce the CDE and FP 3 time when a 30-degree mini-flared tip was used. The benefit accrued by preventing clogging of the needle was significant only in cases with a denser nucleus.Financial DisclosureNo author has a financial or proprietary interest in any material or method mentioned.