R 255
Tradition and new aspects in the development of phacoemulsification-operation-systemsR. Welt
Efficacy, rate of complications and stress on intraocular structures during Kelman-Phacoemulsification are largely affected by the properties of the used operation-system.
The tradition of the development started 1967 with the first use of a prototype. Since 1970 the series 7000/8000 Cavitron/Kelman-Emulsifier was the only one available for a decade, though it had major deficits and security risks. It took until the early 80s when another manufacturer, but the same constructor, presented a significantly improved machine, other producers followed. The emphasis of the further development was on the change from the magnetorestrictive creation of energy with low power output but high heat development to piezo-electric systems, high perfomance fast reacting aspiration pumps, linear or logarithmic control of power output, improved control of turbulences in the anterior chamber.
During the 90s followed improvements of the phacotip to increase the energy gain by conical or step-like interior design, angular ends of tips, rotation additional to longitudinal movement. Now sophisticated electronic control modules are developed that need up to 8 chips and can adapt energy output and aspiration quantity almost without time lag. Energy output is being minimized, bimanual techniques become possible. Phacolasersystems are in the test phase. Their performance doesn´t match the performance of phacosystems of the latest generation.
Augenklinik des Klinikums Ludwigshafen, Bremserstr. 79, D 67063 Ludwigshafen am Rhein, Germany