Pedal Pulse for Phaco
During standard phaco a fragment of lens is fixed at the needle in pedal position 2 and, after complete occlusion, the pedal is moved to position 3 and lens substance emulsification is performed. But sudden breakdown of occlusion is often an unpleasant and unpredictable moment for the surgeon. It may have negative consequences such as acute pressure fluctuations, anterior chamber collapse, and damage of the posterior capsule or endothelium. For prevention of complications during breakdown of occlusion the author has introduced the technique of pedal operation called pedal pulse.
Summary of Content
The suggested technique is as follows. In pedal position 2 which is aspiration and irrigation a lens fragment is fixed at the ultrasound needle window. During vacuum increase, but before complete occlusion occurs the pedal is moved to position 3 which is ultrasound for 0.1 to 0.5 seconds and then instantly back to position 2. The surgeon holds the foot on pedal holding it at the border of positions 2 and 3, waiting for next increase of vacuum. In this case no significant vacuum drop in the system takes place, nucleus fragment is firmly hold with phaco needle, and phaco process goes on effectively and quickly. These manipulations are repeated until complete emulsification of lens substance.
Using the suggested technique of pedal operation provides successful emulsification of lens fragments without complete occlusion, thus minimizing risk of occlusion breakdown, acute pressure fluctuations and intraoperative complications. The surgeon has a possibility to work with lower vacuum settings. A decrease of cumulative dissipated energy during operation takes place.
[ Keyword ]
phacoemulsification / pedal operation
[ Conflict of Interest ]