Feasibility of ultrasound cataract surgery with a 1.4 mm incision

Purpose: To study the feasibility of performing ultrasound (US) phacoemulsi fication cataract surgery through a 1.4 mm incision using conventional phac oemulsification 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 sl eeveless 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 wit h a thermometer to determine whether a thermal burn occurred during the pro cess. A hooked infusion cannula with a widened inner channel and 3 aperture s was used to stabilize the anterior chamber depth. Results: Ultrasound phacoemulsification produced almost no temperature elev ation at the incision site as long as the infusion liquid was adequately ci rculated 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 devel oped at the incision site. The use of a hooked infusion cannula made it pos sible to stabilize the anterior chamber and to apply the bimanual nucleofra ctis technique to emulsify and aspirate the lens nucleus, Conclusion: Using a sleeveless 20 gauge US tip, US cataract surgery was saf ely 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.