Phacoemulsification. By Ian Andersen. History - Kelman. Charles D. Kelman (May 23, 1930 – June 1, 2004). Born in Brooklyn, NY Boston’s Tufts University University of Geneva, Switz. – M.D. Residency in Ophthalmology at Wills Eye Hospital Inspired by dentist’s ultrasonic tools
By Ian Andersen
Charles D. Kelman (May 23, 1930 – June 1, 2004)
Deals with the anatomy, physiology and diseases of the eye.
Greek roots: ophthalmosand logos
“the science of the eyes”
Indian surgeon Sushruta (800 BC) described 76 ocular diseases (of these 51 surgical) as well as several ophthalmological surgical instruments and techniques.
Pre-Hippocrates, Greek physician Galen, Medieval Islam, 17th and 18th centuries.
The first ophthalmic surgeon in G.B. was John Freke, who was so good, that his skill legitimized the field.
ACGME (Accreditation Council for Graduate Medical Education) ADA (American Osteopathic Association)
and are board-certified by the:
ABO (American Board of Ophthalmology)
AOBOO (American Osteopathic Board of Ophthalmology and Otolaryngology)
In 1962, Kelman devised the cryo-probe, a freezing instrument for the extraction of cataracts.
Removal of the lens of the eye (also called crystalline) that has developed opacification, called a cataract.
The lens is made of mostly water and protein. As we age, some of the protein may clump together and start to cloud areas of the eye.
Opaque – Not transparent or translucent, impenetrable to light
It’s not known for sure why the eye’s lens changes, but there are identified factors.
Two main types:
Extra-capsular cataract extraction (ECCE)
In both types, an intraocular lens is inserted.
Preferred method in most cases. It involves the use of a machine with an ultrasonic hand-piece with a titanium or steel tip. The tip vibrates at ultrasonic frequency (40,000 Hz) and the lens material is emulsified. A second fine instrument (called a cracker or chopper) may be used from a side port to break the nucleus into smaller pieces.
After the cataract is emulsified, a dual irrigation-aspiration (I-A) probe or bimanual I-A system is used to aspirate our the remaining peripheral cortical material.
Aspiration – drawing something in, out, up, or through as if by suction
The Actual Thing!