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New Phaco TechnologyNew Phaco TechnologyMark Packer, MD, FACS
Clinical Associate Professor of OphthalmologyOregon Health & Sciences University
Drs. Fine, Hoffman & Packer, Eugene, Oregon
ASCRS 2009
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Mark Packer, MD
Financial Disclosure
Consultant
Abbot Medical Optics, Inc.
Advanced Vision Science, Inc.
Bausch & Lomb, Inc.
Candeo Clinical/Science Communications, LLC
Carl Zeiss Surgical GmbH
General Electric Company
Gerson Lehman Group, Inc.
Ista Pharmaceuticals, Inc.
i-Therapeutix, Inc.
Johnson & Johnson Vision Care, Inc.
Leerink Swann & Company
Sirion Therapeutics, Inc.
Transcend Medical, Inc.
TrueVision Systems, Inc.
Visiogen, Inc.
VisionCare, Inc.
WaveTec Vision Systems
Travel & Honoraria
Endo Optiks, Inc.Synermed Communications
March 19, 2009
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FCataract Surgery
Est. 1862
Refractive Lens Refractive Lens ExchangeExchange
DA
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B-MICS
Kurz S, Krummenauer F, Gabriel P, Pfeiffer N, Dick HB. Biaxial microincision versus coaxial small-incision clear cornea cataract surgery. Ophthalmology. 2006 Oct;113(10):1818-26.
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AMO Signature
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WHITESTAR™ ICE Technology
ICE Pulse“Increase Control and Efficiency”
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WHITESTAR™ ICE Technology
ICE Pulse
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AMO Signature ellips
Longitudinal and transversal motion
Punch separates tip from material
Micro void forms
BSS flows in and accelerates cavitation
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Signature - chop
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Signature - segment
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B & L Stellaris
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Stellaris – EfficiencyStellaris – EfficiencyUnique Dual-Linear TechnologyUnique Dual-Linear Technology
• On-demand independent linear control of aspiration and phaco power
• Pre-programmable foot pedal settings customizable to surgeon technique
• Surgeon control of total phaco time for added safety and efficiencythroughout procedure
• Wireless connectivity for OR convenience
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Stellaris Handpiece
• Six-crystal configuration
• 28.5 kHz for optimized cavitation, and rapid emulsification with minimal thermal loading
• SureLockTM Locking irrigation connectors
• C-MICS and B-MICS capable
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Conventional power modulation
Advanced power modulation with CCS
Traditional pulse: 20 pps Hyperpulse: up to 120 pps-more effective cutting with
less heat
Traditional burst: minimum of 80 ms
Hyper burst: minimum of 4 ms- less energy w/ nuclear removal- less heat build-up- less total energy
Extended range of programmability vs. conventional pulse and burst modes
Custom Control Software (B&L)Custom Control Software (B&L)
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Conventional Advanced power modulation
with CCS
Fixed duty cycle Variable duty cycle (10 – 100%)-To prevent continuous phaco energy even w/ maximum pedal depression
Fixed rise time Variable rise time (waveform pulse)
Unique to Millennium technology- less energy during nuclear removal- less heat build-up; less total energy
Variable Duty Cycle, Rise TimeVariable Duty Cycle, Rise Time
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Stellaris Handpiece –Stellaris Handpiece –Cutting Dynamics Cutting Dynamics
• Increased stroke length for efficient cutting of the nucleus
• Tighter, more focused and consistent delivery of stroke
• CustomControl Software II for customizable, programmable wavefront power modulations for all techniques
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Alcon Infiniti
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Torsional Phacoemulsification
• New energy delivery modality on the INFINITI® Vision System designed to– Reduce repulsion and turbulence– Improve thermal safety profile
• Oscillatory motion at the hub of the phaco tip similar to NeoSoniX® with lower frequency than traditional ultrasound– NeoSoniX® oscillations 100 Hz– Torsional phaco 32,000Hz – Traditional Longitudinal phaco 40,000Hz
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Ozil Reverse Kelman Tip
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Power Modulations
• Provide millisecond level control of US
• Reduce repulsion, improve followability (with transversal or torsional motion delivery)
• Minimize thermal energy, free radical production
• Facilitate B-MICS
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Parameters
• Found at The Expert View
– http://www.finemd.com/theexpertview/
• Or by email
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Thank You
Thank You