Clinical comparison of the Alcon 20,000 Legacy and 10,000 Master phacoemulsification units.

Purpose: To determine whether the use of the Alcon 20,000 Legacy phacoemulsification unit requires less phacoemulsification time and causes fewer intraoperative complications than the Alcon 10,000 Master unit.

Setting: Private practices in Kansas City, Missouri, and Marshalltown, Iowa, USA.

Methods: This prospective study comprised 400 consecutive cases of phacoemulsification with intraocular lens (IOL) implantation performed using the Alcon 20,000 Legacy unit by a high-volume phacoemulsification surgeon (n = 200) and a moderate-volume surgeon (n = 200).

A prospective study of the transition to phacoemulsification and small incision cataract surgery.

Phacoemulsification is an increasingly popular method of performing cataract surgery. The procedure remains controversial. Opponents of phacoemulsification maintain the procedure has an unacceptably high complication rate during transition to the technique.

Irrigation/aspiration handpiece with changeable tips for cortex removal in small incision phacoemulsification.

Cortex removal, especially at the 12 o'clock position, is more difficult with small incision phacoemulsification than with planned extracapsular cataract extraction. In this study an irrigation/aspiration handpiece with changeable tips was used for cortex removal in a large, unselected, consecutive series of small incision phacoemulsification procedures. The instrument provided a safe, effective, and economical method of cortex removal.

A new cannula for removal of 12 o'clock cortex through a sideport corneal incision.

A new cannula for aspiration of 12 o'clock cortex through a corneal sideport incision is now commercially available. The primary difference between this cannula and previously available ones is that the hub has a male adaptor, allowing direct connection to an automated irrigation/aspiration device.

Endocapsular hematoma. Description and treatment of a unique form of postoperative hemorrhage.

Endocapsular hematoma, to our knowledge, is a previously unreported type of postoperative hemorrhage. In this condition, blood collects in the narrow space between the anterior surface of the posterior capsule and the posterior optic surface of a posterior chamber intraocular lens. Endocapsular hematoma differs from anterior chamber hyphema in several ways: the location of the blood is in the endocapsular space, a small amount of endocapsular blood can cause visually disabling symptoms, the blood in the endocapsular space often fails to reabsorb, and neodymium-YAG laser capsulotomy can be used to drain the endocapsular blood into the vitreous cavity.

Severe bradycardia and hypotension following intraocular acetylcholine in a patient who previously tolerated the medication.

Clinical problems with acetylcholine are unusual. The author's experience in the following case suggests that the mechanism of the observed side effects may be something other than drug idiosyncrasy, and stresses the importance of reporting side effects of medications.

A new instrument for surface suction and removal of irrigation fluid during surgery.

A new instrument for removal of intraocular/extraocular irrigating solutions during eye surgery, based on modification of a miniature otologic suction device, is now commercially available.

Modification of an irrigation/aspiration handpiece to provide visual and tactile orientation of the aspiration port.

To perform extracapsular cataract extraction safely the surgeon must know the orientation of the aspiration port of the irrigation/aspiration handpiece at all times. I have modified a commercially available irrigation/aspiration handpiece to allow visual and tactile orientation of the aspiration port even when it is obscured by iris, blood, or cortex.