Ultrasound/Phacoemulsification
I've learned recently that high power ultrasound is being very successfully used to remove cataracts. What are the physical processes behind this, and what are the advantages and disadvantages of this technique compared to conventional surgery. Who are the major manufacturers of the equipment being used for this treatment.
Answered by Richard E. Gans, M. D.
Ultrasound has been used in cataract surgery for the past thirty years. It is a process that was originally created by a United States ophthalmologist, Charles Kelman, M. D. It became popular in the 1960s. With the advent of intraocular lenses and with the limitations of the hardware of the time, this procedure fell into disfavor for many years. In the 1980s, the ultrasound cataract procedure, called PHACOEMULSIFICATION, regained the interest of ophthalmologists, worldwide. Advances in technology made the hardware far more reliable and capable. Newer techniques made the surgery safer and easier. Phacoemulsification is now the procedure of choice for most ophthalmologists in the United States.
In phacoemulsification, an ultrasonic probe is inserted into the eye through a small incision. The probe has three functions: it irrigates fluid into the eye, it vibrates at ultrasonic frequencies, and it aspirates fluid and particles from the eye. The ultrasound is used to dissolve the lens nucleus and the probe aspirates the nuclear particles. All three functions are under constant control by the surgeon.
The advantages of phacoemulsification stem from the ability to operate with a smaller incision than is required for conventional cataract surgery. A smaller opening into the eye means better control over fluid pressure during the eye, more rapid visual recovery, and less surgery-induced astigmatism.
The disadvantages of phacoemulsification are varied. It is a technically difficult procedure to master. Complications may result from lack of experience. The ultrasound can cause damage if used excessively or incorrectly. The equipment required to perform the operation is expensive and complex.
There are many manufacturers of Phaco. equipment. The major manufacturers in this country include Alcon (Series 20,000 Master, Cavitron), Storz (Premiere), Chiron (Phacotron Gold) and others.
PLEASE NOTE: The information contained on this system is not intended to supplant individual professional consultation, but is offered as a community education service. Advice on individual problems should be obtained directly from a professional.
Copyright, 1994. Richard E. Gans, M.D.
Last Modified: August 23, 1996