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Efficient Micro-Torsional Phacoemulsification

Dr. Khiun Tjia displays his adoption of the micro-coaxial technique, his preferred parameters and instrumentation, and his experience with the new INTREPID Micro-Coaxial System for phacoemulsification. This video is associated with Cataract & Refractive Surgery Today's November/December 2007 supplement, "Cataract Surgery's Next Evolution".

Comments (5)

2.2mm temporal clear corneal incisions have a low average, 0.3D induced astigmatism(Masket study)Most importantly, standard deviation is decreased with smaller incision sizes.Superior incisions induce a little more. Post injection 2.2mm incisions are currently 2.3mm; I would expect 1.9mm incisions(post injection 2.0mm) to be clinically insignificant regarding induced astigmatism.Sclerocorneal incisions of 2.2mm also induce very little astigmatism.

Tjia (113 months ago)

I've heard alot of astigmatic neutrality of the micro incisions. I am having difficulty finding statistically reliable data on surgically induced astigmatism (SIA) with the 2.4 - 2.2mm incisions used in microcoaxial phaco technique being described in this series.

O.Barrada (113 months ago)

Safe surgery concepts that I practice routinely following the discussion with you in Atlanta. Thank you for your advice concerning low-setting. Hadisudjono Indonesia

Hadino (113 months ago)

Hi Marcos,Kelman tips by themselves are directly linked to torsional US because only asymmetric/bent tips induce the transverse tip movement, which chafe the nucleus surface.Torsional US is extremely efficient when nuclear pieces can turn and tumble freely, exposing new surface to be chafed off.Bevel down facilitates tumbling greatly and is indeed much safer to the endothelium.The previous worry of capsule rupture is no longer needed because of the minimal post occlusion surge with intrepid FMS and the fluidics settings used.Khiun Tjia

Tjia (113 months ago)

Hello Dr Khiun, congratulations for your beautifull bevel down "vaccum cleanner phaco" technique, favouring downward fragment rotation far from the endothelium. Do you think Kellman tip improves bevel dow?

marcos (113 months ago)