Clinical Ophthalmology (Apr 2022)
Optimization of Phacoemulsification Tip Gauge on the Oertli CataRhex3 in an in vitro Setting
Abstract
John S Peterson,1,2 Michael R Christensen,1,3 Caitlynn Cooper,1,2 Christina Mamalis,1 Ashlie A Bernhisel,1 Brian Zaugg,1 William R Barlow,1 Emilie Ungricht,1,2 Randall J Olson,1 Jeff H Pettey1 1Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, 84132, USA; 2University of Utah School of Medicine, Salt Lake City, UT, 84132, USA; 3Medical College of Virginia/Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USACorrespondence: Jeff H Pettey, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA, Tel +1 801 581 2352, Fax +1 801 581 3357, Email [email protected]: To evaluate the effect of each of the tip sizes available for the Oertli CataRhex3® phacoemulsification machine on efficiency.Methods: Porcine lenses were fixed in formalin for 2 hours, then cut into 3.0 mm cubes. We studied three Oertli tips, all of which had a 30-degree bevel: easyTip 2.2 mm (20G), easyTip 2.8 mm (19G), and CO-MICS (21G). For the 19G and 20G tips, vacuum was set at 600 mmHg, irrigation rate at 50 mL/min, continuous power 70%, and bottle height 85 cm. For the 21G tip, vacuum was set at 450 mmHg; irrigation and power settings were identical to those used for the easyTip tips. We measured time to removal and chatter events to determine efficiency.Results: Results from 20 trials for each tip showed that the larger the gauge size, the more quickly lens fragments were removed. Chatter events demonstrated an increasing trend with smaller tip gauge. The 19G tip used an average time to fragment removal of 2.8 seconds; the 20G, 3.2 seconds; and the 21G, 4.6 seconds. Increasing tip diameter from 21G to 20G decreased emulsification time by 33% (P = 0.02). Increasing the diameter from 21G to 19G further decreased time to emulsification by 42% (P = 0.003). The 21G tip had a mean 1.4 events/cube; 20G, 0.35 events; and 19G, 0.1 events. Differences in mean chatter events for each tip were each statistically significant.Conclusion: These data suggest that when evaluated by chatter events and emulsification time, the 2.8 mm (19G) easyTip proves to have greatest efficiency.Keywords: phacoemulsification cataract, needle, tip size, efficiency, Oertli CataRhex3, longitudinal torsional power
