Phaco Handpiece
Design, Care
and Repair
Phone: 1.800.854.1765
Fax: 1.800.407.2839
Email: [email protected] 1
Phaco Emulsification
• Surgical cataract removal procedure.
• Number 1 therapeutic surgery for Americans over 65 years of age.
1.4 million procedures performed each year.
• Becoming very popular among veterinarians.
History of Phacoemulsification
• Definition: Phaco - lens shaped, relating to a lens. From the Greek phakos, lentil
(lens), anything shaped like a lentil.
• Invented nearly 40 years ago by Dr. Charles Kelman, M.D.
• He received a $280,000 grant and 3 year time limit.
• Live cats were used as test animals. Early results were poor and he had blind cats in
his basement.
• The idea of using ultrasound came to him as he sat in the dentist’s chair.
How does Phaco work?
• Operates on the principle of the Piezoelectric Effect.
• PE discovered by Pierre & Jacques Curie in the 1880’s.
• When crystals are subjected to an electrical field, they expand and contract in direct
proportion to that electrical field.
• Converting electrical energy into mechanical energy.
Phaco Procedure
• Handpiece primed and tuned.
• Small incision in the eye via diamond knife.
• Handpiece tip inserted under cornea.
• Phaco machine powers crystals in handpiece.
• Handpiece tip vibrates ultrasonically thousands of times per second to break up
(emulsify) the cataract.
• Cataract aspirated and flushed with fluid solution.
• Man-made Intra-Ocular lens inserted.
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Phaco Machine
• Microprocessor controlled instrument.
• Has capability of irrigation, aspiration, emulsification, cautery,
and cut modes of operation.
• Functions can be controlled by footpedal, remote control, or on the console.
Phaco Handpiece
A slim, lightweight, piezo-electric, air-cooled,
autoclavable instrument approximately the size
of a magic marker.
Phaco Handpiece External Components
Irrigation Port
Serial # Etching
Aspiration Port
Distal Tip
Stainless Steel or Titanium Casing/Shell
Cord/Strain Relief
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Main Internal Component
• Piezoelectric crystal - each handpiece has a pair or 2 pairs of
ceramic crystals, which vary in size. They resemble thick washers.
When electrified the tip vibrates longitudinally (like a
jackhammer) thousands of times per second. Crystals are
extremely sensitive to changes in temperature.
• There are no moving parts in the handpiece!
Examples of Different Handpieces
Alcon 20,000 Legacy AMO Sovereign Bausch & Lomb
Millennium
OMS Series 3 Chiron Catalyst OMS Series 4
Alcon 10,000 Bausch & Lomb Premier
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Alcon Legacy NeoSoniX
• Alcon’s answer for “Cold Phaco”.
• Includes a motor that oscillates the tip as well as
performing the typical jackhammer effect.
• Moisture intrusion again biggest source of failure.
Alcon Infiniti NeoSoniX
• Same handpiece that functions on the
Legacy system.
Alcon OZIL
• This is the newest handpiece from Alcon. It operates on an
Infinti Phaco System and allows the tip to move back and
forth, sideways and in a circular motion.
Alcon Infiniti Ultrasonic
• Functions on the Infiniti phaco system.
• Frequency is 40,000 Hz.
• An alternative to using the heavy NeoSoniX
or when the doctor does not want to use the
oscillating motion.
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Common Reasons Handpieces Fail
In general, a handpiece will break down after approximately 500 procedures
for reasons including:
• Crystals cracked.
• Cord (wire) damage.
• Connector damage.
• Tip damage.
• Jammed needles.
• Clogged aspiration port.
Common Causes of Handpiece Failure
• Sterilization is the number one cause of failure even when performed properly.
- Repeated exposure to heat and pressure causes the crystals to depolarize, or
causes breaks in the mold/seals which allows moisture intrusion.
- Moisture intrusion will cause electrical failure.
- FOLLOW MANUFACTURER’S STERILIZATION AND COOLING INSTRUCTIONS.
• Rapid Temperature Change.
- Not allowed to naturally cool for at least 15 min.
- Attempts to expedite cooling can damage crystals.
• Mishandling.
- Dropping, pulling rubber boot loose, misaligning pins, cutting cord,
threading improperly.
• Failure to clean.
- Failure to clear aspiration port.
- Build up of debris on connector.
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Repairs
• Only damaged cords, connectors, and shells can be identified by visual inspection.
• For all other problems, the handpiece must be completely disassembled to evaluate
the internal components to determine cause of failure.
• In order to replace any component including the connector and cord, the entire
handpiece must be taken apart and re-assembled.
Handpiece Repair Procedure
• Complete disassembly including transducer assembly from outer shell and transducer.
• Replaceable parts are discarded.
• Remaining parts ultrasonically cleaned/inspected.
• Transducer reassembled using new parts and tested.
• Transducer assembly mated to new tested connector and cable assembly –
tested again then placed in shell housing.
• Autoclaved and re-tested.
Tip Repair
• Tip repair only offered on the Alcon 20,000 series models:
recessed horn allows access.
• Certain models have “reverse thread”.
• Users are prone to over-tightening or “cross-threading” the reverse threaded tips.
• Area between tip and horn very small and disassembly is the safest way to guarantee
all particles removed to prevent going in patient’’s eye during a procedure.
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What is a harmonic scalpel?
• Ultrasonic instrument that cuts and cauterizes at the same time - coagulates blood
proteins - 55,000 Hz.
Ethicon Harmonic Scalpel repair
• Benjamin Biomedical offers repair of all 3 generations of
Ethicon harmonic scalpel.
• Operates at a much lower temperature than other
instruments - electrical surgical unit (ESU).
• Produces very little if any smoke or charring of
tissue - clearer surgical field.
• Use improves recovery time of patient.
Who uses the harmonic scalpel?
• Harmonic scalpel used in all types of open and laparoscopic procedures.
• Very popular for tonsillectomy.
• Ob/Gyn
• Can be used in most cases where ESU is traditionally used.
• Becoming more popular for obvious reasons.
Scalpels vs. Phaco Handpiece
• Scalpels are very similar to phaco handpiece
in technology.
• Also works on the piezoelectric effect.
• Plugs into the host system via a cable and multi-pin
connector.
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What’s inside?
• The scalpel has all of the same type components as the Phaco handpiece.
• Piezoelectric crystals (4)
• Connector
• Cable
• Electrodes
• O-rings, seals
Repair Procedure
• Our repair procedure mimics production process of the manufacturer.
• Complete disassembly of handpiece: discard cable, connector, crystals, electrodes
and o-rings.
• Inspect and clean salvaged components ultrasonically: shell, header assembly,
horn, etc.
• Complete subassemblies and test each: cable assembly, transducer stack assembly,
cable stack assembly, final assembly.
• Final test, autoclave and re-test.
Service options
• Manufacturer does not repair. Handpieces are simply replaced.
• Repair or exchange.
- Within two working days from approval of repair.
• Emergency exchange.
- Customer requires handpiece the next day. Customer handpiece is shipped
same day. Broken handpiece is sent in as an exchange.
- Loaners available in some cases – ask us for details.
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Customer Concerns
• Currently using manufacturer.
- Possible reasons – quality, safety, ease, bad experience with 3rd parties,
does not know alternative exists.
- Possible concerns- Price, poor service, being controlled by manufacturer.
✔ We provide better service and price without sacrificing quality.
• Handpiece repair may void machine warranty.
- Manufacturer reps often use this tired and old scare tactic but will never put it
in writing.
- Customers have many options.
- Machine controls handpiece. Handpiece can never damage machine!
• Why does the handpiece need a full repair if only 1 part has gone bad?
- Disassembly needed to get to components.
- Same wear on each component.
• If only my cord/connector is damaged, why can’t we just replace it?
- Cannot solder new wire to old connector.
• Only the tip is damaged, why do we need full repair?
- Patient safety, design of handpiece, and repair procedure.
- Manufacturer will not do tip repair.
Points to Remember
• Most of the time a handpiece must be disassembled to determine which components
have failed. The machine does not provide a failure analysis on the handpiece. Only
external damage (cord or tip damage) and certain connector problems can be
detected prior to disassembly.
• Manufacturers do not trouble-shoot or do minor repairs. They send out
exchange handpieces.
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At Our Laboratory,
Quality Assurance is Key
1-800-854-1765
www.integratedhealthinc.com
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The Integrated Health Difference
• All repairs utilize new components.
• Cable, crystals, electrodes, connector assembly, o-rings and seals.
• Custom made cable with Aramid fiber.
• We use the same vendors for components as the OEM’s
whenever possible.
• Unmatched engineering support - lead engineer for Alcon and
AMO on staff.
• Annually audited Quality System. At our laboratory, quality
assurance is key.
• Our quality system is a living, breathing thing. It does not sit on
the shelf until audit time. We use it every day.
