Though the back and forth movement emulsifies nucleus, the forward movement of the tip also causes . Longitudinal versus torsional phaco. The Stellaris PC is a compact and mobile unit with a full suite of surgical packs and instruments. "So the ability to plow through a very dense lens increased dramatically." 6 Optimizing machine settings for routine, complex, and femto phaco cases continued from page 5 Figure 1. Phaco Machine and Settings. My preferred technique is quick chop. The Stellaris footpedal can also be programmed to a vertical-only, three-step setting; how-ever, I would encourage surgeons to try Older phaco machines use just gravity to change infusion pressure (bottle height). Subsequent training is provided for new staff, when the system is upgraded, or as requested by the facility. The Stellaris machine had a frequency of 28.8 kHz. May 1, 2014. The foot pedal is located on the back of the phaco machine where it is hung. "This is also critical during vitrectomy surgery, which the Stellaris PC can perform." He notes that post-occlusion surge is more of an issue with a peristaltic-pump-based system. Here's a brief overview of their platforms. FLUIDICS AND MACHINE SETTINGS. Devgan U. Phaco fluidics and phaco ultrasound power modulations. Your handpiece will need to be sterilized after and before each use. . Stellaris Vision Enhancement System for approximately 2 Frequency is fixed and ranges from 27 to 50kHz for most machines. The Stellaris PC ® Phacoemulsification unit (Bausch&Lomb, St. Louis, MO, USA) and the outer diameter 0.74 mm-0.94 mm flared, 30° angulated needle, straight 1.8 mm MICS™ needle were used for each cataract surgery in the modified prechop group. The machine can adjust the bottle height for various phases of the surgery. Frequency and stroke length contribute to phaco power. CTR placement exposure is quite frequent in that setting. "It is more difficult to compare different technologies in a real-world setting," he continued. "Phaco settings come down to personal preference," Dr. Nichamin said. We provide expert phaco handpiece repair on any models and makes. Both Alcon and Bausch and Lomb lenses are utilized at the main campus. The Bausch + Lomb Stellaris uses only longitudinal phaco, but there are multiple modulations of micropulsing and it uses a lower frequency, so the heat signature is lower. We provide expert phaco handpiece repair on any models and makes. Surgical Phaco Basics: Optimising Machine Settings for All Cases Figure 3. [Google Scholar] Ward MS, Georgescu D, Olson RJ. For example, with other machines, a surgeon would need one setting for epinucleus, another for sculpting, and yet another for quadrant removal. "This is where B+L's Stellaris unit really led the way with micro-coaxial phaco by having the 1.8-mm surgery," Dr. Raviv notes. 2) Fluidic Technology Stellaris Elite hosts a Venturi pump, which is a chamber based vacuum system. SUN COAST MEDICAL. Because the Stellaris anticipates changes in pressure in the anterior chamber, I am able to use higher vacuum levels than on earlier phaco machines. The Stellaris phaco machine is capable of vacuum settings of 600 mm Hg and still maintains excellent chamber stability because of its unique ability to simultaneously monitor flow rate and vacuum levels and create feedback through the computer to control pump functions. "If you compare a setting of 50 pulses per second to a setting of 200 pulses per second and if the duty cycle remains at 50 percent, the phaco energy will still be delivered 50 percent of the time for both settings." However, she adds, you can alter the duty cycle to change the on-and-off times. "Nowadays, surgeons can individualize pre-packaged settings of power modulation and fluidics for each stage of nuclear removal. Methods Phacoemulsification systems from 3 major manufac-turers (Abbott Medical Optics WhiteStar Signature Phacoemulsification System, Alcon Infiniti Vision Sys-tem with OZil, and Bausch & Lomb Stellaris Vision Of note, the "Coag" and "Ant Vit" settings must be clicked manually and are not part of the A through F rows. Stellaris incorporates several new features to increase overall efficiency and flexibility.Physically,it is compact,portable and easy to set up.It has a high-definition touch screen interface that provides step-by-step illustrated instructions for setting up the machine,making it easy to train new support staff.Streaming video makes it Effect of bottle height and aspiration rate on postocclusion surge in Infiniti and Millennium peristaltic phacoemulsification machines. However, in comparing the 2 phaco machines, no mention was made of the phaco needles used, the power settings apart from mention of continuous use, and the fluidics settings. Whether it is sharing system settings across machines, phaco handpieces, Capsule-Guard ® I/A and cataract tubing packs, Stellaris makes it easy to offer multi-specialty services with minimal specialization. And for more extreme (unforseen) situations, our warehouse team is ready to run more backup equipment or supplies to the surgical location if needed. Small OR footprint; Wireless foot pedal; Easy to set-up, priming and tuning of tubing and handpieces OR-Optimized for you and your staff. unguarded phaco tip. The Stellaris™ System was designed with the help of leading cataract surgeons from around the world. Alcon Centurion Vision System. Ophthalmol Clin North Am. The benefits of a sub 2-mm incision include a reduction in surgically induced astigmatism, a reduction in endothelial cell loss and increased visual recovery. KEY FEATURES Combined Surgical Ability The Stellaris PC is a combined vitrectomy and phaco- emulsification system with an integrated 532-nm laser Video 2: Vitrectomy Over Detached Retina Maximizing Surgical Efficiency With the Stellaris PC Anterior and posterior segment capabilities make this an appropriate machine for busy surgery centers. 2006; 19 (4):457-468. Newer machines used a forced infusion such as pressure plates on a soft bag of BSS (Alcon centurion) or air pumped into the rigid glass bottle (B&L Stellaris). The longitudinal stroke of the 3 machines at different phaco powers was statistically significantly different. B&L STELLARIS phacoemulsification system in biaxial and standard phacoemulsification . The entire phacoemulsification procedure can be boiled down to four parameters: (1) bottle height (irrigation or inflow of balanced salt solution [BSS]), (2) aspiration (rate of BSS outflow), (3) vacuum (how much grip is applied), and (4) phaco energy (think: how hot the knife is as if you are cutting through butter). With the Stellaris PC dual-linear footpedal control, I use only one setting. I myself presently use the Sovereign cataract extraction system (Advanced Medical Optics, Inc., Santa Ana, CA) and a 19-gauge 0º phaco tip. Normally, all phaco procedures have two phases: first, creation of fragments, which requires sculpting or chopping; second, the removal of the fragments in a controlled approach. The tip now . Features such as a bright touch screen LCD, wireless footpedal, brushed aluminum trim, dust covers, extra tips, handpieces and so much more are included with this sale. Tech Update. The Stellaris uses only longitudinal phaco, but it has multiple modulations of micropulsing. Single-port Vitrectomy Cutter Available in 20, 23, and 25 gauge New 7,500 cpm cut rate, for efficient vitreous removal Cuts only in the forward position Bi-Blade™ Vitrectomy Cutter 23, 25 and 27ga with cut rate up to 15,000 cpm The Centurion® Vision System is a phacoemulsification device intended to improve surgical control and hit cataract refractive targets. J Cataract Refract Surg. . Designed for ease of use, efficiency, versatility, and reliability, the compact Stellaris PC is a fully-integrated machine for posterior, anterior and combined procedure. regardless of the brand of phaco machine. 0 Stellaris 66% Duty Cycle (60%) Ozil Torsional CW (100%) Ozil Mixed (Torsional 100% - Longitudinal 60%) Mark E. Schafer, PhD. This single modification reduces the size of the incision, decreases . Dr. Prathibha Console, foot pedal and hand piece.with the connections The console computer based controls the functions of the machine Settings of parameters flow rate, power, vacuum are preset and represent the maximum level that will be achievable during phaco by the surgeon Multimodel panel diplay Memory button- surgeon setting saved It has a variety of programmable options and can be used like a traditional phaco foot pedal only for the up-down or pitch direction. I have four settings programmed into the machine (Table 1). Power modulation and pulse shaping are used to optimize longitudinal ultrasound delivery. Phacoemulsification is the gold standard for cataract surgery,1 and for good reason—over the decades it has been shown to be a safe and efficacious procedure that returns excellent visual outcomes to patients with cataracts. The Bausch & Lomb Stellaris Phaco Machine. The Stellaris PC platform provides a high-performance, feature-rich, combined experience that leverages Bausch + Lomb's legacy of vitreoretinal surgical innovation with the demonstrated excellence of the Stellaris phacoemulsification platform.The Stellaris PC allows surgeons to have true "procedural choice" by providing the most advanced technology for both vitreoretinal and cataract . Manual Concept Phaco procedures are catching up to manual cataract procedures in India, as seen in surgical centers such as the Aravind Eye Hospitals, which have 50 phaco machines, including four cutting-edge . phaco machines that feature a vertical footpedal with three settings, this dual-linear footpedal enables me to manage both pitch and yaw planes and to simultaneously control irrigation, ultrasound, and aspiration. The Stellaris machine had the highest stroke extent (139 μm). Phaco machines . Occlusion is mandatory to move fragments to the iris plane. For surgeons transitioning to microincisional phacoemulsification equipment. The Stellaris PC Vision Enhancement is capable of 1.8 mm MICS phacoemulsification like the Stellaris Vision Enhancement System and high performance 5000 cuts per minute sutureless vitrectomy with the company's existing proprietary 25-gauge system of instruments for retinal surgery, along with standard 23- and 20-gauge instruments. Our company has more than 10 years of combined experience repairing Stellaris phaco handpieces. Whether it is sharing system settings across machines, phaco handpieces, Capsule-Guard ® I/A and cataract tubing packs, Stellaris makes it easy to . Whether it is sharing system settings across machines, phaco handpieces, Capsule-Guard ® I/A and cataract tubing packs, Stellaris makes it easy to offer multi-specialty services with minimal specialization. The machine displays these settings as "U/S AVE," which stands for "ultrasound average," and "EPT," which is "elapsed phaco time." The total energy delivered into the eye is the product of the phaco power multiplied by the time the power is on, known as the absolute phaco time (APT). The torsional machine averaged less phacoemulsification needle time (83 ± 33 seconds) than the transversal (99 ± 40 seconds; P=.21) or longitudinal (110 ± 45 seconds; P=.02) machines; the . 1. 2) Back-up Phaco Machines (Every Time) We always bring a backup phaco. At the same machine settings, nuclear density and the phaco method also affect the amount of surge seen. settings is an important factor in successful cataract surgery, but it is often overlooked or underemphasized in phaco education," Dr. Chang said. Bottle height. The foot pedal charges by simply resting in place against the phaco machine. among 3 phacoemulsification platforms and across selected phacoemulsification power and various flow settings. With a variety of cutting options, Stellaris Elite™ adapts to a wide range of procedural needs. This new program will discuss principles for adjusting and optimizing phaco machine settings for both routine and complex cases. The new Centurion Vision System is the only intelligent phacoemulsifier technology that optimizes every moment of the cataract surgical procedure. It was easy for Dr. Shultz to get used to the dual linear foot pedal and vacuum-based technology. Of note, the "Coag" and "Ant Vit" settings must be clicked manually and are not part of the A through F rows. Bausch & Lomb Stellaris™ Vision Enhancement System. This stops much of the wear and tear a handpiece will experience every day. Another fluidics advance for Stellaris is the wireless, Bluetooth, dual linear foot pedal (Fig. All repairs are done at our facility and come with 6 month warranty. However, the surgeon must understand the principles For a quick chop technique, I most often use a linear ultrasound power of 30%, 80 pulses/s, and 50% duty cycle. The benefits of a sub 2-mm incision include a reduction in surgically induced astigmatism, a reduction in endothelial cell loss and increased visual recovery. This allows if a machine is acting up, we have another on-hand to keep the day running. ultrasound power settings increase the chatter and tur-bulence of nuclear particles within the anterior chamber. We do not know whether a Devine needle was used for the 1.8 mm surgery with its very narrow central lumen or what type of needle was used on the Infiniti. What do I need to know about the foot pedal? When the 3 machines were compared while using the same displayed power setting, the temperatures measured using Infiniti were lower than the other 2 machines at each time point past 0 seconds. Whether you are performing standard or micro-incision cataract surgery (MICS) procedures, Stellaris provides . The system consists of a main housing unit which contains a user interface screen and the surgical modules, and a Foot Control, infrared remote control, handpieces, and other accessories. . Upgrade compatible with existing Stellaris PC. Stellaris - Designed to Expand Your Control Stellaris is the next generation of phaco surgical systems that is designed to accommodate your surgical technique. Oertli phaco handpiece sterilization is important to extending the lifespan of your handpiece. The device features an all-titanium lightweight ultrasound handpiece, and its low-cost reusable tubing kit can be autoclaved and used repeatedly, according to the company. Other benefits of Stellaris Elite that Dr. Mauer has realized include fewer post-occlusion surges, improved cutting ability, improved chamber stability, and reduced number of people in the operating room by one due to the simplicity . Stellaris (Bausch & Lomb). The dual linear foot pedal allows me to use mostly phacoaspiration on the downstroke of the pedal and more phaco power, when needed, through my foot's . THE BASICS. Phaco power is used to emulsify the nucleus. The training includes system startup, accessories and connections, priming and settings adjustment consistent with the instructions provided in this user manual. Personal settings for Standard Chop Analysis of the Cutting Forces using Different Phacoemulsification Modalities, Session 1-J Stellaris - Ease of Use Competitive advantages of Stellaris • Sleek and elegant footprint • Adjustable 18'' Screen 2008; 34 (8):1400-1402. "This is where B+L's Stellaris unit really led the way with micro-coaxial phaco by having the 1.8-mm surgery," Dr. Raviv notes. Stellaris Elite™, designed for the efficient cataract operating room and Stellaris PC designed for the Efficient Cataract and Vitreoretinal surgical practice are compatible on multiple fronts. The Phaco System 2000 is an ergonomically designed platform with large, easy-to-read displays and a user-friendly console. Chopping dense cataract using the Bausch + Lomb Stellaris machine Figure 2. . The new system automatically and continuously adapts to changing conditions within the eye, provides greater anterior chamber stability during each step of the surgery . The Stellaris PC system provides a high-performance experience that demonstrates Bausch & Lomb's expertise in vitreoretinal surgery with the Stellaris phaco system's features. My program includes three settings (Table 2). The frequency of the Whitestar Signature machine was 29.0 kHz in longitudinal mode and 38.0 kHz with the Ellips FX handpiece. It is a versatile platform that allows surgeons the flexibility to . At Augusta University, we also have the Bausch and Lomb Stellaris phaco machine which uses a venturi system rather than the peristaltic pump of the Alcon platform. The foot pedal is located on the back of the phaco machine where it is hung. The followability with vacuum-based phaco machines holds onto fragments of cataract in a more consistent manner. "The Stellaris's system allows the surgeon to control vacuum at the tip of the device during phacoemulsification, as well as irrigation and aspiration," he says. Learn more at MyAlcon today! All three of the newer phaco devices employ sophisticated technology. The longitudinal stroke of the 3 machines at different phaco powers was statistically significantly different. The frequency of this machine is 28.5kHz, so it has a lower heat signature, and you can increase efficiency by using a waveform shaping of the pulses. as well as in the Stellaris (Bausch & Lomb) and Infiniti Vision System (Alcon), Dr. Fishkind said. control of aspiration and phaco power Wireless connectivity for operating room convenience Standard Phaco My default settings Phaco power Micropulse 10% max power, 85 pps, 35% duty cicle Vacuum 0.8-0.9 mm lumen 400-450 mm Hg Up to 0.7 mm 550-600 mm Hg Slow . The Stellaris is a phacoemulsification platform that can be customized to offer excellent control through various fluidic and ultrasound options depending on the surgeon's needs. Several new refractive surgical platforms have been introduced recently and many ophthalmologists are discovering they find the new technologies to be more efficient and produce better results. I asked several surgeons which machine and phaco settings they use and what their phaco settings are. The phaco machine aims to balance fluidics within the eye, while delivering ultrasonic energy and vacuum in order to emulsify and aspirate the cataract through a small incision. The Stellaris machine had a frequency of 28.8 kHz. Fragment removal is assisted by partial to complete occlusion phaco. Get contact details & address of companies manufacturing and supplying Phaco Machine, Phacoemulsification System, Phacoemulsification Machine across India. The settings of the phaco machine were as follows: the longitudinal . The Bausch and Lomb Stellaris PC is a combined ophthalmic microsurgical system used for cataract surgery in hospitals and clinics. grades. Let's review the typical progression of steps: All repairs are done at our facility and come with 6 month warranty. The right Stellaris phaco handpiece repair professionals can restore your Attune handpiece to like-new situation. Floppy iris cases are very common at the VA. Stellaris Elite has a dual linear foot pedal that can be customized for the surgeon to adjust phaco and vacuum based on individual preferred settings. Phaco Fundamentals: Optimizing Phacodynamics for Brunescent and Challenging Cataracts PARTICIPATE AND CLAIM CME AT YOUR CONVENIENCE. Methods Experiments were performed . Cataract surgery can be divided into multiple steps, each of which benefits from optimized fluidic settings. Whether it is sharing system settings across machines, phaco handpieces, CapsuleGuard® I/A and cataract tubing packs, Stellaris makes it Stroke length is the length of movement of the needle and ranges between 2-4 mil. To compare vacuum rise time, vacuum limit accuracy, and occlusion break surge of 3 new phacoemulsification machines.Jules Stein Eye Institute and Depa… About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators . Only Stellaris® gives you vacuum based StableChamber® fluidics with the option of DigiFlow® pressurized infusion settings. The irrigation system on phaco machines is typically is just an adjustable bottle held higher than eye to allow infusion of fluid. The Stellaris machine had the . Because surge results from occlusion break at the maxi-mum vacuum level, tip occlusion is required. Stellaris, designed for the efficient cataract operating room and Stellaris PC designed for the Efficient Cataract and Vitreoretinal surgical practice are compatible on multiple fronts. These cutting edge machines are fully refurbished and are ready for immediate sale. And the Stellaris PC takes the established Stellaris platform and adds to it the ability for phaco, vitrectomy and combined procedures. Re-designed interface with enhanced clarity and ease of use. Yes. The Stellaris® Vision Enhancement System has a modular design which enables it to be upgraded to take advantage of advances in technology. Longitudinal phacoemulsification using the Signature was generally cooler than when using the Stellaris. Background To compare the heat production of 3 different phacoemulsification machines under strict laboratory test conditions. The foot pedal charges by simply resting in place against the phaco machine. This is a longitudinal device that uses a straight or Kelman bent needle. To compare vacuum rise time, vacuum limit accuracy, and occlusion break surge of 3 new phacoemulsification machines.Jules Stein Eye Institute and Depa… Every phacoemulsification system on the market can provide patients with excellent postoperative vision, with very low complication rates, however, they do differ in . What do I need to know about the foot pedal? Find here Phaco Machine, Phacoemulsification System manufacturers, suppliers & exporters in India. 3). Small OR footprint; Wireless foot pedal; Easy to set-up, priming and tuning of tubing and handpieces For example when the vacuum goes up during segment removal the bottle height typically will need to be higher to maintain the anterior chamber. choosestellaris.com Wireless footpedal with integrated laser controls With fully integrated laser Even more intuitive With enhanced procedural versatility A single pedal controls all your procedural needs. Stellaris Elite introduces Attune Energy technology to the phaco market with a six-crystal handpiece that delivers optimized 28.5 kHz frequency for consistent power delivery and increased stroke length. Our company has more than 10 years of combined experience repairing Stellaris phaco handpieces. OR-Optimized for you and your staff. More specifically, the thermal behavior was analyzed between the torsional modality of the Infiniti system and longitudinal modalities of the Abbot WhiteStar Signature Phacoemulsification system and Bausch and Lomb Stellaris system. This explains why surge may be absent with sculpting, but quite evident with chopping where the phaco tip impales the . It delivers fluidics and power for exceptional safety and efficiency. The right Stellaris phaco handpiece repair professionals can restore your Attune handpiece to like-new situation. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators . The most vital aspect of phaco handpiece care you should master is the sterilization process.
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