Phaco Tip 151:
Hold Instruments Short

Phaco is equivalent to shipbuilding in a bottle. Although it would be impossible, the best way to do the latter would be to send tiny workers into the bottle. Next best would be to have the workers at the bottle entry site, or as close to it as they could get as they approach the bottle from the outside.

The above is an example of the fulcrum effect. The bottle opening (phaco incision) is the fulcrum and the workers are the surgeon’s fingers. The further the fingers are from the eye, the greater their excursion must be (and the less their precision) for any instrument movement except those made along the axis of the incision.

The lesson here? Hold the phaco tip, chopper, etc. as short (close to the eye) as possible for greater manual dexterity and maneuverability.

* Phaco Tip TM of Richard J. Mackool, M.D.

The parameters (instrument settings) and incision size presented here have been established by the surgeon and do not reflect recommendations by Alcon.