Trilinear Phaco Using the Dual Linear Foot Pedal and Burst Mode Phacoemulsification Terence M. Devine, M.D. USA.

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Presentation transcript:

Trilinear Phaco Using the Dual Linear Foot Pedal and Burst Mode Phacoemulsification Terence M. Devine, M.D. USA

Phaco Technology Ultrasonic Fluidics Power Linear Power Flow Control VacuumControl Chamber Stability Linear Power Pulser Power Burst Mode Power

Fluidics Power “Cutting Efficiency”

Fluidics Power Safe Easy Quick

Flow “Followability”

Vacuum “Holding Force”

Ultrasonic Power “Emulsification”

Tri-Linear Phacoemulsification

Bausch & Lomb Millennium™ Venturi

Dual Linear Footpedal

PITCH

YAW

“Non-occluded State” Gas + - +

Gas Flow Valve T From Handpiece Microprocessor Foot Pedal YAW

Flow “Followability” Non-occluded State Flow Vac Flow 50 100 150 200 vacuum 50 100 150 200 250 300 17 23 29 35 40 46 Flow “Followability”

Tip Occluded Vacuum “Holding Force”

FLOW 20 Panel Control VS Gas-Pedal Control YAW

Safety and Efficiency Flow Low Flow High Flow

“Burst Mode” Case 1

Fluidics Power Dual Linear Foot Pedal Burst Mode Cutting Efficiency

Fluid wave Followability Flow Impact Lens “Chatter”

Pulser Power Off On Off On Followability Cooling Off

Standard Pulse ON OFF Burst 2 ON OFF Time

Standard Pulse Peak Energy Total Energy Burst 2 Followability Cooling

Millennium™ Burst Modes Rise Time 1 Rise Time 2 Pulse Duration 80 – 600 ms Examples: “Bimanual phaco” 1+ - 2+ cataracts Pulse Duration 160 - 600 ms Examples: 2+ - 3+ cataracts

“Carrier Frequency” is fixed. Millennium™ = Legacy® = Sovereign® = 28.5 KHz 40 KHz

Millennium™ = 28.5 KHz Pulser Linear Power Burst Pulse Duration (1 – 20 pulses/sec) OR Linear Power (0 – 100%) Burst Pulse Duration (80 – 600 ms)

Transient Cavitation Bubbles Bubble Size Lower Frequency Bubble Energy Cutting

Transient Cavitation Bubbles 28.5 KHz 40 KHz 73 Microns 52 Microns E = 2.76 E = 1.00

? Ultrasonics Sonics Stroke Intensity = 5 inches 40,000 Hz 28,500 Hz

Eye World October 2004 Dr. Howard Fine Millennium™ Burst Mode Sovereign® White Star Legacy® NeoSonix Clear Corneas at 24 hours 100% 100% 98% ≥ 20/40 100% 94% 96%

Trilinear Phaco Linear Power or Burst Flow Vacuum YAW 17 - 46 cc/min 50 - 300 mmHg Linear Power or Burst

“Burst Mode” Case 2

“Burst Mode” Case 3

Phaco Technology Ultrasonic Fluidics Power Flow Control VacuumControl Chamber Stability Linear Power Pulser Power Burst Mode Power