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Allen Chiang, Sunir J. Garg, Marc J. Spirn, Jason Hsu, Richard G. Lane, Carl D. Regillo, Richard S. Kaiser, Arunan Sivalingam, James F. Vander; Removal of Posterior Segment Retained Lens Material Using The OZil Torsional Phacoemulsification Handpiece During Pars Plana Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6114.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the performance and utility of the OZil torsional phacoemulsification handpiece during pars plana vitrectomy (PPV) for the removal of posterior segment retained lens material.
This was a retrospective interventional case series of 9 eyes that underwent PPV for retained lens material between September and December 2010. Following 23-gauge PPV, the torsional phacoemulsification handpiece (OZil, Infiniti Vision System, Alcon Inc., Fort Worth, Texas) with the irrigating sleeve removed, was inserted through a 20-gauge sclerotomy for the removal of posterior segment retained lens material. Retained lens fragments were graded by nuclear density (1 to 4+) and size as a percentage of the total cataract. Primary outcome measures consisted of total ultrasound time, phaco time, and torsional time. Secondary outcome measures included any intraoperative complications or mechanical malfunctions (e.g., handpiece clogging).
Nine eyes successfully underwent pars plana lensectomy (PPL) with the OZil handpiece. Mean nuclear density was 3.78+ and mean size was 51% of the total cataract. Mean total ultrasound time was 33.9 seconds, mean phaco time was 9 seconds, and mean torsional time was 24.7 seconds. All cases demonstrated excellent followability based on independent observations by the various surgeons. In one case, 2 inferior retinal breaks were identified during PPV, but were unrelated to PPL. No other intraoperative complications or mechanical issues were observed. In particular, clogging of the handpiece by nuclear material was not seen in any case.
Use of the OZil torsional emulsification handpiece during PPV for retained lens material represents a novel approach with advantages over the conventional fragmatome, including improved followability and efficient removal of dense lens material due to the addition of torsional ultrasonic movement.
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