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Abstract
Phacomulsification is a technique which was invented and developed by Charles D. Kelman, during the 1960s (Kelman, 1967). Evolution was to improve chamber stability, increase flow & vacuum, reduce heat and fluid use.
• Bimanual phaco (Phakonit, MICS):
This procedure uses separate irrigation instrument and sleeveless phaco tip to remove cataracts. Irrigation is provided through an irrigating chopper instead of through the phacoemulsification hand piece.
This can be done through incisions less than 1mm & is associated with improved maneuverability and visualization as well as producing less refractive error (Weikert, 2006).
Bimanual Phaco (or phakonit) was basically developed to reduce the size of the incision; this was done by removing the sleeve from the phaco needle (Agarwal et al, 1998).
• Micro coaxial phaco:
In moving towards smaller incisions, there is the option of maintaining coaxial irrigation with the phaco needle.
The reported incision is only 2 mm for the main corneal incision and less than 1.0mm for the accompanying paracentesis (Weikert, 2006).
Advances in cataract surgery have focused on the technologies that reduce the incision size seeking faster rehabilitation. Predictability of surgical performance, the superior fluidics of the phacoemulsification machine, modulated ultrasound energy, and new-generation intraocular lenses (IOLs) led to the evolution of coaxial phacoemulsification through a small incision.