Comparison of Mini-Flared 45

1
Comparison of Mini-Flared 45 Kelman and
Mini-Flared OZil 12 Tips in Resident and
Attending Torsional Phaco Cases

• Sherleen Chen, M.D. and Roberto Pineda II, M.D.

Massachusetts Eye and Ear Infirmary Harvard
Medical School Boston, Massachusetts
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Purpose
Both have 45 bevel at tip

• Background
• Torsional phaco more effective with angulation of
  Kelman tip than with straight phaco tip
• New OZil 12 developed for surgeons less
  comfortable with the standard 20 angulation of
  the Kelman tip
• Goal
• Compare safety and efficiency of the Mini-flared
  OZil 12 tip to the Mini-flared 45º Kelman in
  resident and attending torsional phaco cases

Mini-Flared OZil 12
12 shaft angulation
Mini-Flared 45 Kelman
20 shaft angulation
Straight phaco tip 0 shaft angulation
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Methods

• 48 consecutive cases in 42 patients using
  torsional phaco performed by residents and
  attendings
• Cases randomly assigned to use of Mini-flared 45
  Kelman tip or Mini-flared OZil 12 tip
• Data recorded
• Complications
• Nuclear Density determined pre-operatively
• Calculated as LOCS III NC grade LOCS III NO
  grade
• Ex. NC2NO2C2 Nuclear Density of 4
• Metrics
• Cumulative dispersed energy (CDE)
• Total ultrasound time (sec)
• Aspiration time (sec)

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Results-Safety

• No phaco complications encountered
• Posterior capsular rent occurred during cortical
  removal with I/A on one resident case

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Results-Efficacy
No statistically significant differences
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Results-Efficacy
No statistically significant differences
7
Results-Efficacy
No statistically significant differences
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Conclusions

• No statistically significant difference between
  tips in safety or efficacy
• Sample size may be too small to achieve
  statistical signficance
• Both tips worked well
• For teaching or early learning curve in torsional
  phaco, we would suggest starting with the OZil 12
  for easier visualization of the port, since
  efficiency of both tips appears to be similar