Journal of Clinical and Experimental Ophthalmology
Open Access
ISSN: 2155-9570
ISSN: 2155-9570
Silvio Di Nardo*
Objective: A comprehensive technical and biomedical analysis of ultrasound-induced effects during Phacoemulsification Cataract Surgery (PCS) and an assessment of the potential risks associated with ultrasound emulsification.
Methods: Whole-exome Modeling ultrasound wave propagation and intensities using the Finite Element Method (FEM). Cavitation onset was experimentally validated in a pressure chamber observed with a high-speed camera. The thermal effects of ultrasound energy were estimated through established physical and thermal models and confirmed in a cuvette setup using thermistor probes.
Results: At the distal end of the PCS tip, the ultrasound wave intensity reached 0.2 W/mm², resulting in ocular tissue displacements in the anterior chamber below 2 µm. The temperature rise in the anterior chamber was less than 0.2 ?/s. Both observations indicate negligible mechanical and thermal risk to ocular tissues. High-speed imaging confirmed cavitation confined to the tip region. Emulsification efficacy was maintained even under conditions that suppressed cavitation, including elevated ambient pressures and cavitation-inhibiting fluids. Results indicate that mechanical fragmentation by tip oscillation (“jackhammer effect”) is the only relevant emulsification mechanism, while cavitation plays a negligible role. Acoustic streaming was observed during ultrasound excitation without phaco sleeve. During phacoemulsification, the sleeve suppressed acoustic streaming into the anterior chamber.
Conclusion: The findings validate the safety of ultrasound-based PCS and confirm that tissue fragmentation is primarily driven by the oscillating tip’s direct action.
Published Date: 2025-11-14; Received Date: 2025-10-13