Microcoaxial phacoemulsification

Osher, Robert H.; Injev, Valentine P.

doi:10.1016/j.jcrs.2006.10.058

Cited by 42 publications

(22 citation statements)

References 12 publications

(10 reference statements)

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“…Recent studies comparing biaxial phacoemulsification and microcoaxial phacoemulsification [18][19][20][21][22] describe both techniques as safe and effective with comparable advantages and disadvantages. It seems that at present, most surgeons prefer microcoaxial phacoemulsification over biaxial phacoemulsification based on their level of experience with the coaxial technique.…”

Section: Discussionmentioning

confidence: 99%

Biaxial microincision versus coaxial small-incision cataract surgery in complicated cases

Kurz¹,

Krummenauer²,

Thieme³

et al. 2010

Journal of Cataract and Refractive Surgery

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Section: Discussionmentioning

confidence: 99%

Biaxial microincision versus coaxial small-incision cataract surgery in complicated cases

Kurz¹,

Krummenauer²,

Thieme³

et al. 2010

Journal of Cataract and Refractive Surgery

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“…In microcoaxial phacoemulsification, irrigation, aspiration, and phacoemulsification are performed with the same instrument (phaco handpiece), used in standard coaxial phacoemulsification. [1][2][3] The only difference between the 2 techniques is the smaller main incision in microcoaxial phacoemulsification, which is the result of the development of the phaco tip sleeves. In biaxial MICS, however, the irrigation and phacoemulsification aspiration steps are separate; an irrigation chopper is used for irrigation and a sleeveless phaco tip for aspiration and phacoemulsification.…”

mentioning

confidence: 99%

Coaxial, microcoaxial, and biaxial microincision cataract surgery

Can¹,

Takmaz²,

Yıldız³

et al. 2010

Journal of Cataract and Refractive Surgery

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“…Generally, bimanual phacoemulsification has the advantage of small incision sites (individually 1.2 mm-1.4 mm in length) in comparison to a relatively large incision (1.8 mm-3.2 mm) in coaxial phacoemulsification (Gajjar et al 2007;). Coaxial phacoemulsification, however, has advantages of a single incision site, better temperature control, easier handling, better sealability, and several fluidic benefits (Osher and Injev 2007). Even though both types of phacoemulsification offer advantages and are still in use, it has been reported that bimanual phacoemulsification has more disadvantages such as limited infusion of the irrigation solution (Osher and Injev 2007), chamber instability caused by leakage at the two incision sites (Gajjar et al 2007;), higher possibility for bacteria to enter through the multiple incisions (Gajjar et al 2007), and regular occurrence of physical wound trauma due to tight angular movement of the instrument through the small incisions ).…”

Section: Introductionmentioning

confidence: 99%

Combined micro and macro additive manufacturing of a swirling flow coaxial phacoemulsifier sleeve with internal micro-vanes

Choi

Yamashita

Sakakibara

et al. 2010

Biomed Microdevices

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Microstereolithography (microSL) technology can fabricate complex, three-dimensional (3D) microstructures, although microSL has difficulty producing macrostructures with micro-scale features. There are potentially many applications where 3D micro-features can benefit the overall function of the macrostructure. One such application involves a medical device called a coaxial phacoemulsifier where the tip of the phacoemulsifier is inserted into the eye through a relatively small incision and used to break the lens apart while removing the lens pieces and associated fluid from the eye through a small tube. In order to maintain the eye at a constant pressure, the phacoemulsifier also includes an irrigation solution that is injected into the eye during the procedure through a coaxial sleeve. It has been reported, however, that the impinging flow from the irrigation solution on the corneal endothelial cells in the inner eye can damage these cells during the procedure. As a result, a method for reducing the impinging flow velocities and the resulting shear stresses on the endothelial cells during this procedure was explored, including the design and development of a complex, 3D micro-vane within the sleeve. The micro-vane introduces swirl into the irrigation solution, producing a flow with rapidly dissipating flow velocities. Fabrication of the sleeve and fitting could not be accomplished using microSL alone, and thus, a two-part design was accomplished where a sleeve with the micro-vane was fabricated with microSL and a threaded fitting used to attach the sleeve to the phacoemulsifier was fabricated using an Objet Eden 333 rapid prototyping machine. The new combined device was tested within a water container using particle image velocimetry, and the results showed successful swirling flow with an ejection of the irrigation fluid through the micro-vane in three different radial directions corresponding to the three micro-vanes. As expected, the sleeve produced a swirling flow with rapidly dissipating streamwise flow velocities where the maximum measured streamwise flow velocities using the micro-vane were lower than those without the micro-vane by 2 mm from the tip where they remained at approximately 70% of those produced by the conventional sleeve as the flow continued to develop. It is believed that this new device will reduce damage to endothelial cells during cataract surgery and significantly improve patient outcomes from this procedure. This unique application demonstrates the utility of combining microSL with a macro rapid prototyping technology for fabricating a real macro-scale device with functional, 3D micro-scale features that would be difficult and costly to fabricate using alternative manufacturing methods.

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Microcoaxial phacoemulsification

Cited by 42 publications

References 12 publications

Biaxial microincision versus coaxial small-incision cataract surgery in complicated cases

Biaxial microincision versus coaxial small-incision cataract surgery in complicated cases

Coaxial, microcoaxial, and biaxial microincision cataract surgery

Combined micro and macro additive manufacturing of a swirling flow coaxial phacoemulsifier sleeve with internal micro-vanes

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