Phacoburns: Experimental Study for Evaluation of Risk Factors

Abstract

OBJECTIVES: The thermal side-effects during phacoemulsification were measured with a special temperature sensor during 8 s of continuous phacoemulsification. Over 500 measurements were performed in a constructed model of the anterior chamber and in enucleated eyes of pigs. SETTING: Department of Ophthalmology, General Hospital Barmbek, Hamburg, Germany. MAIN OUTCOME MEASURES: The influences of the anterior chamber volume, phacoemulsification power, pulse rate, hardness of the lens, viscoelastic material and insufficient or interrupted irrigation and/or aspiration were examined. RESULTS: With uninterrupted aspiration and irrigation, the temperature of the irrigation fluid was measured after 1–2 s in the anterior chamber. At the phaco sleeve, however a temperature increase was detected. Without irrigation, temperatures of more than 100 °C developed at the phaco sleeve. During pulse mode and with reduced power, temperature increase was reduced by half. CONCLUSIONS: The main risk factor for phacoburns is the interruption of irrigation. Application of viscoelastic material, reduced anterior chamber volume, very small tunnel incision, hard nuclei and high ultrasonic power without pulse are further important risk factors.