Sometimes new does not mean safer

Abstract

Constantin-Dan Bordeianu Private Practice, Ploiesti, Prahova, Romania I was extremely interested in an article by Masuda et al,1 recently published in your Clinical Ophthalmology journal, especially after reading in the abstract that the phaco tip is the only surgical instrument required “for lens cleavage and removal”.1 The authors assert that this new technique maintains a stable intraocular pressure during hydrodissection and lens removal, whereas the existing techniques induce anterior chamber instability because three instruments are successively inserted and withdrawn. However, the attached video contradicts these assertions, as the following were observed: (i) a second instrument is used to split the grooved nucleus, to chop the quarters, and to manipulate the fragments; (ii) in all, the authors used more than three instruments: cannula for saline or for ophthalmic viscoelastic device, phaco tip, chopper, and irrigation/aspiration cannula; and (iii) the wound leakage around the chopper is obvious. Given these conditions, how could the intraocular pressure be considered stable?  View the original paper by Masuda and colleagues

Keywords

• cataract surgery
• excessive lens mobilization
• isometric phacoemulsification