Feasibility of ultrasound cataract surgery with a 1.4 mm incision

Purpose: To study the feasibility of performing ultrasound (US) phacoemulsification cataract surgery through a 1.4 mm incision using conventional phacoemulsification equipment but removing the infusion sleeve from the US tip. Setting: Department of Ophthalmology, Jikei University, Tokyo, Japan. Methods: The infusion sleeve was removed from a 20 gauge US tip, and the sleeveless tip was inserted in a 1.4 mm incision in a postmortem porcine eye, providing infusion through a side port; phacoemulsification was performed with the US tip occluded, Temperature at the incision site was measured with a thermometer to determine whether a thermal burn occurred during the process. A hooked infusion cannula with a widened inner channel and 3 apertures was used to stabilize the anterior chamber depth. Results: Ultrasound phacoemulsification produced almost no temperature elevation at the incision site as long as the infusion liquid was adequately circulated around the US tip. With the 20 gauge US tip, an adequate volume of leakage was maintained through the 1.4 mm incision; no thermal burns developed at the incision site. The use of a hooked infusion cannula made it possible to stabilize the anterior chamber and to apply the bimanual nucleofractis technique to emulsify and aspirate the lens nucleus, Conclusion: Using a sleeveless 20 gauge US tip, US cataract surgery was safely performed through a 1.4 mm incision without producing thermal burns at the incision site. J Cataract Refract Surg 2001; 27:934-940 (C) 2001 ASCRS and ESCRS.