Pulsed electron avalanche knife: new technology for cataract surgery.
BACKGROUND
The pulsed electron avalanche knife (PEAK-fc) is a new pulsed electrosurgical device that allows for precise, "cold" and traction-free tissue dissection.


OBJECTIVE
To evaluate the surgical applicability, safety and potential complications of PEAK-fc in complicated cataract surgery.


METHODS
The study included five children with congenital cataracts, two patients with advanced senile cataracts, six adults with mature cataracts, three of them with posterior iris synechia, three patients with post-traumatic cataracts with zonulolysis, one patient with intumescent traumatic cataract and three patients with massive anterior capsule opacification. Anterior and posterior capsulotomies, iris synechiolysis, dissection of anterior capsule opacification and fibrotic scar tissue were performed. PEAK-fc was set at voltages of 500-700 V, pulse duration of 0.1 m and repetition rate of 40-100 Hz.


RESULTS
Anterior and posterior capsulotomies were successfully and safely performed in all eyes. The edges of capsulotomies appeared sharp, showing only limited collateral damage. PEAK-fc worked best by just gently touching the capsule, thereby avoiding tractional forces or pressure on the lens capsule. Posterior iris synechiae could be released and anterior capsule opacification was dissected without complications.


CONCLUSIONS
PEAK-fc is a very helpful cutting device for complicated cases of cataract surgery, especially for mature and congenital cataracts, traumatic zonulolysis or anterior segment complications after intraocular inflammation.
Priglinger
Siegfried G
SG
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Mathildenstr 8, 80336 Munich, Germany. siegfried.priglinger@med.uni-muenchen.de
Palanker
Daniel
D
Alge
Claudia S
CS
Kreutzer
Thomas C
TC
Haritoglou
Christos
C
Grueterich
Martin
M
Kampik
Anselm
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000869:Anterior Eye Segment / Q000601:surgery; D002386:Cataract / Q000151:congenital / Q000209:etiology; D002387:Cataract Extraction / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D002675:Child, Preschool; D004598:Electrosurgery / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome