|
Welcome to
|
|||
|
|
Ocular Surgery News Fairhope, Ala. - The Gravlee Safety Bevel phacoemulsification probe offers a shorter, sharper, continuous cutting edge with a smaller surface area to be occluded, and safety factors to decrease the complications of unplanned vitrectomies. Created by Joseph F. Gravlee, Jr., M.D., the U.S. patented Gravlee Safety Bevel has been used in more than 800 cases by Dr. Gravlee and is being manufactured by Mastel Precision Inc. (Rapid city, S.D.) "There has been a trend toward less power, using more cutting and more vacuum as opposed to the use of sound waves to cavitate and emulsify the cataract," Dr. Gravlee told Ocular Surgery News. "I was trying to think of ways that would improve the cutting ability of the probe that would use less power and be more gentle, producing less trauma." Cutting and occlusion advantages "Phacoemulsification with the Gravlee Safety Bevel probe is quicker (than conventional probes)," Dr. Gravlee said, "My average case takes about 15 minutes." Dr. Gravlee added that the rapid removal also depends on the aggressiveness of the surgeon. According to Dr. Gravlee, the Safety Bevel probe appeals to surgeons at all levels of ability due to the safety, as well as to aggressive surgeons where speed is an issue. Dr. Gravlee said it is like putting a trephine knife into the eye. "It is counterintuitive that it would be safer than a standard probe," Dr. Gravlee said. "The probe has great occlusion, as well. It is an odd marriage, but if you think about it, Mother Nature has to obey the laws of physics."
The Gravlee Safety Bevel has a continuous cutting edge formed at an inner surface of a cylindrical shaft. Cutting the shaft at an angle and beveling the exterior surface back from the inner portion of cylindrical shaft forms the cutting edge. Phacoemulsification with the Gravlee Safety Bevel prove is fast and efficient, coupled with great predictability, resulting in improved surgical outcomes, according to Robert I. Schnipper, M.D., who presented his experiences with the probe at the American Society of Cataract and Refractive Surgery meeting in Seattle. With phaco tip technology, the goal is to occlude well and to cut well. "Cutting increases as the degree of the tip increases, " Dr. Schnipper said. "But occlusion decreases as the degree increases." Dr. Schnipper referred to the 30° tip that most cataract surgeons use as a compromise. According to Dr. Schnipper, the Gravlee Safety Bebel prove is the best of both worlds. It cuts like a 45° tip and it occludes like a 30° tip. Dr. Schnipper compared data from surgery performed using the Gravlee Safety Bevel compared with the standard tip. All other parameters were identical. Reduction in ultrasound timeThere was a 32%
decrease in ultrasound time using the Gravlee Safety Bevel.
The cutting surface for this tip efficiently sculpted hard nuclei
with occlusion mode phaco cutting. The tip had good
followability and good purchase on the edge of the phaco needle. "The Gravlee Safety Bevel decreased my ultrasonic usage in hard cataracts by approximately 32%," Dr. Schnipper said. "It is a very inexpensive, safe and painless way to improve phaco efficiency." The posterior capsule must travel a longer distance in order to be ruptured with the Safety Bevel probe if it should trampoline up. Also, should that distance be traveled, then a flat surface will be encountered, rather than the sharp leading edge of the traditional probe. Low vitrectomy rate According to Dr. Gravlee, the vitrectomy rate was less than one-half of 1%, or three out of his series of 800 cases. The three vitrectomies were technique-related, such as due to IOL placement, a tumbling nucleus and extreme patient movement from an undiagnosed sleep apnea patient. None were due to the Gravlee Safety Bevel probe. The sharper cutting and better occlusion makes for more precise and quicker surgery with less ultrasonic energy being transmitted to the endothelium. Consistent with Dr. Gravlee, one to two plus nuclear sclerotic cataracts can usually be removed in the phacoaspiration mode with only vacuum. At times, ultrasonic energy is only necessary to clear the barrel of the probe. Also, less balanced salt solution is irrigated through the anterior chamber with quicker cases. Fast recovery of vision is made possible with less postoperative corneal edema. On the first postoperative day, 20/20 vision is achievable. Dr. Gravlee said his surgical volume has increased since he began offering this procedure.
by Sara E. Smith - Staff Writer
|
|
|
