Experimental evaluation of Experimental evaluation of various disposable micro-various disposable micro-

incision knives in incision knives in comparaison to a diamond comparaison to a diamond

knifeknife

G. LESIEUR

ALBI

P: Royalty from a PhysIOL ophthalmic productA: PhysIOL consultant

E: Travel expenses reimbursed by Bausch and Lomb

Wound architectureWound architectureA A bad architecture can be bad architecture can be

encountered in biaxial as well as in encountered in biaxial as well as in coaxialcoaxial

Minicoaxial Incision C-MICSBiaxial Incision B-MICSJ.P BerdahlJ.P Berdahl

Corneal wound architecture and integrity after phacoemusification J Corneal wound architecture and integrity after phacoemusification J Cataract Refract Surg 2007;33:510-515Cataract Refract Surg 2007;33:510-515

less stress in « minicoaxial »? but Asp Rate 12cc/mnless stress in « minicoaxial »? but Asp Rate 12cc/mn

MethodMethod

► MicroCutMicroCut► Disposable Trapezoidal BladeDisposable Trapezoidal Blade► Multisize incision 1.2/1.8/2.2/2.4mmMultisize incision 1.2/1.8/2.2/2.4mm► Adapted for micro <2mm and mini Adapted for micro <2mm and mini

incisions between 2 and 2.8mmincisions between 2 and 2.8mm

Prospective and comparative studyProspective and comparative study 20 Diamond, 20 MicroCut, 16 Intrepid and 20 Kai MICS 20 Diamond, 20 MicroCut, 16 Intrepid and 20 Kai MICS

KnivesKnives

► Measuring penetration and cuttingMeasuring penetration and cutting► 0.4 micron polyurethane film0.4 micron polyurethane film► Results expressed in NewtonResults expressed in Newton

ResultsResults

00,20,40,60,8

11,21,4

Penetration Cutting

DiamondMicrocutIntrepidKai

◊Best penetration (less force required) with Kai and PhysIOL MicroCut Knives◊Best cutting (less force required) with Diamond, Kai and Alcon Intrepid Knives

ResultsResults PenetrationPenetration MicroCut better than Diamond MicroCut better than Diamond p<0.001p<0.001 Kai better than Diamond Kai better than Diamond p<0.001p<0.001 CuttingCutting Diamond better than Kai, Intrepid and MicroCut Diamond better than Kai, Intrepid and MicroCut p<0.001p<0.001

PhysIOLPhysIOL MicroCutMicroCutExcellent penetration Excellent penetration Control of incision enlargementControl of incision enlargementValid alternative to the diamond Valid alternative to the diamond knifeknife

How to avoid incision injury?How to avoid incision injury?

Posterior stromal tear Descemet tear

Step 1 Trapezoidal incision increases instruments mobilityStep 2 Oblique introduction of the phaco Dewey tip MST (1.2mm)Step 3 Hydrochopper introduction (1mm)

3 steps for incision integrity3 steps for incision integrity

20 G

Thank youThank you

g.lesieur@iridisinnov.fr