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    Head to head: Balanced phaco tip more efficient than Kelman tip

    Chatter minimal at all longitudinal power settings below 75%; increased with higher power


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    Results supported the general clinical impression that balanced tips are more efficient. While the precise differences in tip efficiency varied by power applied, the balanced tip removed lens fragments in an average of 29% less time than the Kelman tip at the same power setting (p < 0.0001), Dr. Zaugg noted.

    In addition, 100% torsional power averaged 45% faster (p = 0.0028) compared with 60% power regardless of the longitudinal power used.

    Chatter was minimal at all longitudinal power settings below 75% and increased with higher longitudinal power. There was a significant increase in chatter at 100% longitudinal power compared with 75% regardless of the torsional power applied (p < 0.0001). The balanced tip showed significantly more chatter than the Kelman tip with 100% longitudinal power at both 60% torsional power (p < 0.0001) and 100% torsional power (p = 0.0022).

    “My sense is that more ophthalmologists are moving to the balanced tip,” Dr. Zaugg said.

    “These findings help validate the general clinical opinion that the balanced tip is more efficient and help explain the mechanic,” he said. “We still have a couple of surgeons who use Kelman tips. Tip selection can be a preference for how one instrument feels and responds over the efficiency of the tool.”

    Data also suggest the balanced tip may provide patient safety benefits. More efficient phacoemulsification should translate into shorter operating times and less energy being applied to the eye.

    “Being more efficient in the eye is a constant goal,” Dr. Zaugg said. “We can achieve greater efficiency by adding the balanced tip to our armamentarium.”

    Brian E. Zaugg, MD

    p: 801/581-7899

    This article was adapted from a presentation by Tyler D. Boulter, BS, at the American Society of Cataract and Refractory Surgery annual meeting. Brian E. Zaugg, MD, and Boulter have no relevant financial interests.

    Fred Gebhart
    The author is a correspondent for Urology Times, a sister publication.

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