title: [Phacoemulsification of human lens nucleus with a water jet].
abstract: BACKGROUND
  Today, phacoemulsification with ultrasound represents the gold standard in cataract surgery. Nevertheless, new technologies for this operation are being developed to reduce the loss of endothelial cells, the heating of the tissue, and the size of the accesses. In addition to bimanual phacoemulsification, laser phacoemulsification, and mechanic phacolysis, the waterjet is discussed as an alternative.
  
  
  METHODS
  Human soft and hard nuclei of the lens obtained by extracapsular cataract extraction (ECCE) were divided in the water bath with the waterjet, whereby the parameter pressure was varied and the time needed for fragmentation was recorded.
  
  
  RESULTS
  In spite of different consistencies, all nuclei could be divided under the direct force of the waterjet. For the emulsification of hard nuclei of the lens, a pressure of no less than 10 bar was necessary. This value was obviously higher than a lens capsule can tolerate. For the fragmentation of soft nuclei of the lens with lower acceptable pressures of 5 bar, comparatively long operating times (in some cases over 5 min) were measured. This means that also in these cases a pressure of 10 bar was required.
  
  
  CONCLUSIONS
  Intraocular use of the waterjet with direct effect of the stream with these pressures is not justifiable. Instruments for waterjet phacoemulsification should be developed which pose no danger to the corneal endothelium and lens capsule.
authors.affiliation: Universitäts-Augenklinik Halle-Wittenberg, Magdeburger Strasse 8, 06122 Halle. frank.wilhelm@medizin.uni-halle.de
authors.forename: F
authors.initials: F
authors.lastname: Wilhelm
authors.forename: A
authors.initials: A
authors.lastname: Holtkamp
authors.forename: G I W
authors.initials: GI
authors.lastname: Duncker
authors.forename: J
authors.initials: J
authors.lastname: Darman
authors.forename: M
authors.initials: M
authors.lastname: Knorrn
mesh_terms: D046508:Culture Techniques; D006801:Humans; D006874:Hydrostatic Pressure; D007907:Lens Nucleus, Crystalline / Q000473:pathology; D018918:Phacoemulsification / Q000295:instrumentation*; D007507:Therapeutic Irrigation / Q000295:instrumentation
vernacular_title: Zerkleinerung humaner Linsenkerne mittels Waterjet.