eye surgeon Santa Monica
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Dr. Seibel's Textbook
on Cataract
Surgery
Phacodynamics, Fourth Edition!
How to Customize Cataract Surgery for Each Patient.
Dr. Seibel's textbook, Phacodynamics,
is a result of his commitment to innovation and excellence
in eye surgery. An international
bestseller on the subject of cataract surgery, Phacodynamics explains
in fine detail the methods and motivations behind each and
every step for achieving ultimate individualization of refractive
surgery. Dr.
Seibel pioneered this specialized method of study to help surgeons
develop a deeper understanding of the fundamental surgical
principles, as well
as the minute details of phaco-machine technology.
- Over 300 informative figures and illustrations
- Learn the latest machine technologies and surgical techniques
- Identify and distinguish between flow pumps, vacuum pumps, and ultrasound power modulations
- Customize surgery for each patient
Phacodynamics: Mastering the Tools and Techniques of Phacoemulsification
Surgery, Fourth Edition
has been completely revised and substantially
expanded to include detailed descriptions and illustrations of the latest machine
technologies and surgical techniques available today.
New topics included that are unique to this Fourth Edition:
- Bimanual Microincision Phaco
- Ultrasound Power Modulations including Burst and Pulse Modes
- AquaLase and Laser Surgical Technologies
- Expanded Horizontal Chopping Techniques including PreChop
- Vertical Chopping Techniques and Instrumentation
- Bimanual Irrigation and Aspiration
- Phacodynamic Complications
- Phacodynamics of Surgical Instrument Design
 This new edition not only covers the most up-to-date technology but is enhanced by improved schematic graphics, illustrations, and descriptions.
In addition to examining the intricate relationship between the surgeon and the phaco machine, this book provides an in-depth analysis of the basic mechanical physics of the surgical maneuvers and equipment as they combine to produce the best possible results.
The focus on technology centers on the relationships among flow rate, rise time, vacuum, and ultrasonics, as well as many other key surgical concepts. It details such topics as: machines, including a schematic machine; ultrasound; phaco tip angles; phaco needle dimensions and shapes; the logic behind setting machine parameters; and individual phaco techniques. Current information is provided on equipment and accessories, including new pumps such as the rotary vane pump and the scroll pump. For the first time, pumps are divided into flow-based and vacuum-based categories and then compared and contrasted for a better understanding. No matter which technique is used, this book leads you through each surgical situation with comprehensive clarity to demonstrate what the next step should be. |
Published by:
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From the Publisher:
Dear Dr. Seibel:
I wanted to follow up on the release of your new edition of
"PHACODYNAMICS: Mastering the Tools and Techniques of
Phacoemulsification Surgery, Fourth Edition." The release of the book
was another success for you!
Over the years, your books have a had a tremendous impact on
ophthalmology and all of cataract surgery. PHACODYNAMICS has become
the bible for ophthalmologists worldwide. Your signature style of
illustration along with your unique presentation of clinical material,
surgery, and technology make it a one-of-a-kind for cataract surgery,
and medicine.
The sales of the book through the last 12 years continues to be great.
It ranks as one of the top books ever in the history of our company
for ophthalmology and is number one for cataract surgery!
I believe you are the only author in the history of ophthalmology to
have been both the sole author and illustrator of a
textbook like yours, let alone into four editions!
You should be proud of the international acclaim the book has and how
you have helped countless surgeons to perform cataract surgery better
on tens of thousands of patients. Thanks for your time, expertise, and
attention to detail and education. The profession and medicine are
better for it.
- John Bond
Vice President
SLACK Incorporated Book Publishing
Reviews:
This book will be utilized best by that cataract surgeon who wants to truly understand the technology that he holds in his hands. I am sure that this added level of comprehension would easily enhance any cataract surgeons capabilities.
- Leonid Skorin, Jr., MD, DO, FAOCO
Journal of the Osteopathic College of Ophthalmology and Otorhinolaryngology
The other books tell you what to do. This book tells you why and how. The illustrations are superb, demonstrating clearly how phacoemulsification works and why some maneuvers must, necessarily, work better than others. This book is critical if you want to master the art and science of phacoemulsification.
- Paul S. Koch, MD, Koch Eye Associates, Warwick, RI
I learned more about phacoemulsification surgery (in this book) than in all previous course time. The text is brilliantly illustrated. The diagrams amplify and refine the written paragraphs. This is a book that every cataract surgeon must review. This book has my highest recommendation. I wish I had written it.
- Frederick S. Brightbill, MD Archives of Ophthalmology
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Sections Include:
·
Machine Technology
·
Logic of Setting Machine Parameters
·
Overview of Phacoemulsification Techniques
·
Irrigation and Aspiration Techniques
·
Physics of Capsulorhexis
Special Features:
- Completely updated and expanded to reflect all the latest techniques and technology.
- Description of ultrasonics including new tip designs, styles, sizes, and the effects on fluidics.
- Includes a detailed look at the clinical application of fluidics.
- Detailed description and logic of chopping techniques including Dr. Nagahara's Chop Technique and the Seibel Chopper.
- Explains why to use specific methods.
- Categorizes and compares flow-based and vacuum-based pumps.
- Discussion and illustrations of ultrasound relating to nuclear density.
- Enhanced schematic graphics, illustrations, and descriptions.
- Includes a total of 133 color illustrations.
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Table of Contents
Dedication
Acknowledgments
Preface to the Fourth Edition
Preface to the Third Edition
Preface to the Second Edition
Preface to the First Edition xiv
Foreword to the Fourth Edition
Foreword to the Third Edition
Section One: Machine Technology
Machine Overview
Bimanual Microincision Phaco: Alternate Irrigation Path
Foot Pedal
Irrigating Bottle
Flow Pumps
Flow Pumps: Overview and Peristaltic Pump
Scroll Pump
Flow Pumps: Direct Control of Flow and Indirect Control of Vacuum
Flow Pumps: Tip Occlusion Effects on Flow and Vacuum
Flow Pumps: Direct Vacuum Control with Tip Occlusion
Rise Time: Flow Pumps
Rise Time: Flow Pump Compliance
Rise Time: Flow Pump Venting and Vacuum Limit Preset
Schematic Machine: Flow Pump
Relationship Among Flow Rate, Rise Time, and Vacuum
Relationship Between Flow and Vacuum 1
Relationship Between Flow and Vacuum 2
Vacuum Pumps
Vacuum Pumps: Overview and Venturi
Diaphragm Pump
Rotary Vane Pump
Vacuum Pumps: Direct Control of Vacuum and Indirect Control of Flow
Vacuum and Flow Pumps: Flow Resistance
Vacuum Pumps: Control of Flow and Grip; Vacuum Transfer Upon Tip Occlusion
Vacuum Pumps: Direct Control of Vacuum and Grip
Vacuum Pump Emulation by Flow Pumps
Control Strategy: Flow Pump vs Vacuum Pump
Rise Time: Vacuum Pumps
Vacuum Pumps: Relationship Between Rise Time and Vacuum
Vacuum Pumps: Pedal Control of Rise Time
Clinical Fluidics
Fluidic Resistors Affecting Flow: Vacuum Pump
Fluidic Resistors Affecting Flow: Vacuum Pump vs Flow Pump
Fluidic Resistors Affecting Vacuum: Flow Pump
Vacuum Degradation in Aspiration Line
Bottle Height: Relationship to Flow
Baseline Resistance to Flow
Flow Control: Vacuum vs Flow Pumps
Compliance and Air Venting
Compliance and Fluid Venting
Surge
External Surge Suppression
Ultrasound
Ultrasound Overview
Sculpt vs Occlude
Ultrasound: Gel vs Solid
Ultrasound Power Modulations: Linear Continuous
Ultrasound Power Modulations: Fixed Panel Continuous
Ultrasound Power Modulation: Pulse Mode
Ultrasound Power Modulation: Burst Mode
Ultrasound Power Modulation: HyperPulse
Ultrasound Power Modulations: Decreased Ultrasound Time
Pulse and Burst Modes Contraindication with Sculpting
Phaco Needle Tip Angles: Occludability 1
Phaco Needle Tip Angles: Occludability 2
Tip Angles and Aspiration Port Surface Area
Phaco Needle Dimensions
Ultrasonic Cavitation and Needle Design
Thermal Implications of Ultrasound: Needle Designs
Alternate Modalities of Phacoemulsification: Ultrasound Variations
Alternate Modalities to Ultrasound: Laser
AquaLase and Laser Surgical Techniques
Irrigation and Aspiration Tips
Individual Machine Characteristics
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Section Two: Logic of Setting Machine Parameters
Overview of Logic Behind Setting Machine Parameters
Anterior Chamber Currents
Flow Rates and Currents
Force and Currents
Flow and Vacuum Settings 1: Distal Followability
Flow and Vacuum Settings 2: Proximal Followability
Flow and Vacuum Settings 3: Grip
Control Inputs and Aspiration Port Occlusion: Flow Pumps vs Vacuum Pumps
Parameter Modulation with Hardware Modification
Sculpting Settings: Vacuum, Flow, and Bottle Height
Sculpting Settings: Ultrasound
Linear Phaco Sculpting
Quadrant Settings 1
Quadrant Settings 2
Settings for Quadrant/Fragment Emulsification: Balancing Fluidics and Ultrasound
Phaco Chop Settings: Horizontal Chop
Modified Horizontal Chop: Stop and Chop 1
Modified Horizontal Chop: Dynamic Linear Parameter Adjustment
Vertical Chop Settings 1
Vertical Chop Settings 2
Epinucleus Settings 1
Epinucleus Settings 2
Cortical Removal Settings
Viscoelastic Removal Settings
Section Three:
Overview of Phacoemulsification Techniques
Overview of Phaco Methods
Sculpting Angle of Attack
Minimum Groove Width
Posterior Groove
Judging Groove Depth
Peripheral Groove
Physical Obstructions to Sculpting
Use Low to Moderate Scope Magnification
Tip Manipulations for Sculpting Groove
Avoiding Iris During Sculpting
Layers of the Lens
Hydrodissection Fluid Dynamics
Nuclear Rotation: Torque Principles
Nuclear Rotation: Clinical Application of Torque
Rotating Nucleus: Pulling with Phaco Tip
Rotating Nucleus: Effects of Friction
Optimal Instrument Placement for Nuclear Manipulation
Nuclear Segmentation 1
Nuclear Segmentation 2
Nuclear Segmentation 3
Nuclear Segmentation 4
Fault-Line Phaco
Horizontal Chopping Techniques 1
Horizontal Chopping Techniques 2
Horizontal Chopping Techniques 3: Seibel Chopper
Horizontal Chopping Techniques 4: Flat-Head Phaco Tip
Vertical Chopping Techniques
Chopper Instrumentation
Akahoshi Prechop
Vacuum Seal
Vacuum Seal: Needle Bevel
Fragment Manipulation 1
Fragment Manipulation 2
Fragment Manipulation 3
Fragment Manipulation 4: Viscodissection
One-Handed Strategies 1
One-Handed Strategies 2
Pivot Around Incisions 1
Pivot Around Incisions 2
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Section Four: Irrigation and Aspiration Techniques
Cortical Classification
Cortical Removal: Large Pieces Instead of Small Bites
IA Port Turned Posteriorly
Capsule Vacuum
Manual Cortical Removal
901/4 and 451/4A Tips
Bimanual Irrigation and Aspiration
Using the IOL to Help Remove Cortex
Epinuclear Mobilization via Cortical Pulley
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Section Five: Physics of Capsulorhexis
Stress and Strain
Shear vs Rip
Capsulorrhexis with Shearing
Capsulorrhexis with Ripping
Maintaining Chamber Depth
Combining Techniques
Capsulorrhexis Initiation 1
Capsulorrhexis Initiation 2
Capsulorrhexis Initiation 3
Capsulorrhexis Initiation 4
Anterior Cortical Opacities
Capsulorrhexis Enlargement
Section Six: Phacodynamic Complications
Complication 1
Complication 2
Complication 3
Complication 4
Complication 5
Complication 6
Appendices
Appendix A: Implied Surface Area in Units of mm Hg
Appendix B: Aspiration Port Surface Area Derivation
Appendix C: Summary of Pressure Terminology
Appendix D: Phacodynamic Analysis in Instrument Design
Bibliography
Index
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Phacodynamics 
