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Cautery in Ophthalmology: An Overview of Uses and
Systems
ForceEZ
Electrosurgical
Generator

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Posted:February18,2014 Tweet Like 1 Email Print Comments(0)

ForceFX
WendyW.Lee,M.D.,M.S. Electrosurgical
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Generator

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Why Cautery:
Theuseofcauterydatesbacktoprehistorictimeswhenhotstoneswereused Surgistat
Electrosurgical
tostopbleeding.Still,inmoderndays,cauteryisparamount,andanabsolutely Generator
essentialitemtohaveinthemajorityofophthalmicprocedures.

Hemostasisremainsthemostimportantroleofcautery.Withouthemostasis,weruntheriskofbleedsleadingtothe
worstcasescenarioofaretrobulbarhematomaandblindness.Hemostasisallowsforasaferandmorefavorable
outcome.Butbesideshemostasis,cauterycanbeusedforotherpurposes.Weuseitcommonlyinophthalmologyto
inducepunctalstenosisforpatientswithdryeyes.Weuseittocloseconjunctivalincisions.Weuseitasasurgical
marker.
Related Categories

What You Need to Know: CauterySystemsOphthalmicSurgery

Heatisgeneratedthroughanelectricalcurrentandflowstoametaltiptocoagulatebloodvesselsandstop
bleeding.Electrocauterycomesintheformofmonopolarorbipolar.Withmonopolarelectrocautery,thecurrentis RefractiveProductsandEquipment
appliedthroughahandheldactiveelectrodeandtravelsbacktothegeneratorthroughaninactiveelectrode
attachedtothepatient(thegroundingpad),sothepatientispartoftheelectricalcircuit.Theinactiveelectrodeis RetinaProductsandEquipment
typicallyplacedonalargeareaofthebodytoavoidheatconduction.
BipolarCauterySystems
Withbipolarelectrocautery,thecurrentispassedbetweenoneforcepstiptotheother,andalimitedamountoftissue
iscauterizedinbetween.Thecurrentisspreadmorewithmonopolarelectrocautery,thereismoretissuedamage, ForcepsTips
andrecoveryofthetissuetakesabitlonger.Bipolarcauteryallowsformoreprecisedeliveryoftheheat.Lateral
thermaldamageisgreaterwithunipolarcauterythanbipolarcautery.
IntraocularLenses(IOL)

Forthesereasons,Iusebipolarcauterymoreoften,butmanyusemonopolarcauterybecausethismethodtendsto
decreasesurgicaltimewiththecapabilitytocutandcoagulatewiththesameinstrument.
Quick Quiz
Belowisadiscussionandcomparisonofavarietyofcauteryunits.
Thepatientdepictedinthephotowas
scheduledforasurgicalprocedure
whichwasabortedatthebeginningof
Wet-FieldHemostatic Coagulator thecase.Thephotowastaken2weeks
afterthescheduledsurgery.Whatwas
themostlikelyintraoperativeevent?
BeaverVisitec
a.postinjectionretrobulbar
Thisunitisdesignedtoprovideprecisehemostasiswithreduced hematoma
peripheraltissuetrauma.Controlledradiofrequencydiathermydelivers b.infectionfromnonsterile
targetedcoagulation.Theboxweighsonly4lbs.andrequires100240 instruments
WetFieldHemostaticCoagulator c.cauteryfire
VAC,65VA,50/60Hz.Thereareavarietyoftips,includingeraser
d.allergicreactiontosurgical
instruments,forcepsandcables. BeaverVisitec
drapes

Wet-Field Osher ThermoDot Marker checktheanswer

BeaverVisitec
Featured Products
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11/21/2016 CauteryinOphthalmology:AnOverviewofUsesandSystems|ophthalmologyweb.com
Thisbipolarinstrumentisdesignedtocreateaninkfree WetFieldOsherThermoDotMarkerBeaverVisitec Featured Products
finedotontheeyethatcanbeusedasaprecisereference
pointforavarietyofocularprocedures,includingtoricintraocularlensimplantation.Asopposedtoatraditional Smartphone
BasedRetinal
surgicalmarkingpen,thismarkwillnotsmearandwilllastthedurationofthesurgery. ScreeningSystem
DEYE,TheModern

Force Triad Energy Platform DayDigital...

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Covidien
ZEISSAngioPlex
TheForceTriadenergyplatformprovidescuttingandcoagulation,bipolar OCTAngiography
functionalityandvesselsealinginonegenerator.ItincludesValleylab Designedtomake
modeforelectrosurgery.ThecompanyofferstheValleylabExchange capturingclear,3D...
ForceTriadEnergyPlatform
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SoftwareUpdateSystemtoupdateyourcurrentsystem.
Covidien

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Force FX Electrosurgical Generator C with Instant

Response Technology
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Keepupwithourlatestarticles,newsandevents.
TheForceFXisdesignedtoworkatlowerpowersettingstominimizethe
Plus,getspecialoffersandmoredeliveredto
riskoftissuedamage.ItcancutthroughdifferenttissueswithaPERof98 ForceFXElectrosurgical
yourinbox.
incut,andiscapableofautomaticallyadjustingtotissuechanges.This GeneratorValleyLab

maintainspowerdeliveryandminimizesdrag. YourEmailAddress

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TheForceEZunitisdesignedformostmonopolarandbipolarprocedures
withaPERof97incut.Italsoadjustsautomatically,liketheForceFX.
OphthalmologyWebwantstohearfromyou.
ForceEZElectrosurgicalGenerator Submityourcasestudies,clinicalpearls,practice

ValleyLab managementtips,editorial,orothermanuscripts.

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SurgiStat Electrosurgical Generator II

TheSurgiStatisacompactunitdesignedforgeneralelectrosurgery
procedures.Simplestouse,itoffersbothmonopolarandbipolaroutputs.

SurgiStatIIValleyLab

20-Watt Bipolar Coagulator

Kirwan
With20wattsofpower,thisgeneratoriswellsuitedforophthalmologyuse.
Itoffersadjustablesettingsandprovidesanaudibletoneduringoutput
poweractivation.Withtouchpadcontrolsandfootswitchactivation,its
simpletouseaswell.

TIPS

Asasidenote,belowaresomeofmyfavoritebipolarcauterytipsthatcan
beusedwithanyoftheaboveunits.Theproductspicturedbeloware
manufacturedbyKirwanSurgical.Ihaveusedmany,andmyfavoritesso
fararethecoated,nonstickforcepstips. 20WattBipolarCoagulatorKirwan

Bayonet:Iusethesetipsfordacryocystorhinostomies,opticnervesheath
fenestrations,orbitaltumorexcision,andanyotherprocedurewheredeep
cauterymaybeneeded.

Semkin:Thesearemyfavoriteforcepstipsfordirectbrowplasties.

http://www.ophthalmologyweb.com/FeaturedArticles/154802CauteryinOphthalmologyAnOverviewofUsesandSystemsWendyWLeeMD/ 2/4
11/21/2016 CauteryinOphthalmology:AnOverviewofUsesandSystems|ophthalmologyweb.com

Jewelers:Thesearemymost
commonlyusedforcepstips.Iuse
theseforchalazia,lidlesions,
blepharoplasties,ptosisrepairs,
enucleations,Mohs
reconstructions,etc.Theycomeinavarietyofsizesandstyles.

Colorado Needle
Stryker
Thisneedleisamonopolarelectrodewithasharptungstentipforsofttissuedissection.Itoperatesathigh
temperatureswithinsulationdesignedtopreventunwantedtissuedamage.

Peak PlasmaBlade Device

Medtronic
ThisunitispoweredbythePULSARIIGeneratorandisuniqueinthatit
usesradiofrequencyenergy.Itisadisposable,softtissuedissection
instrumentthatusesbrief,highfrequencypulsesofradiofrequencyenergy
toinduceelectricalplasmaalongtheedgeofa12.5umthin,99.5%
insulatedelectrode.Radiofrequencyreducesthermalinjurydepthwhile
maintainingcuttingeffectivenessandhemostaticability,eveninliquefied PeakPlasmaBladeDevice
tissueorblood.Thisdeviceoperatesatlowertemperaturesthantraditional Medtronic
electrosurgicaltechnology(40170degreesCelciusvs.200350
degreesCelcius).

OnelastsidenotethatIwillmentionisthehottemperaturedisposablecauterydevice.Theseareusefulforclinic
proceduresorintheemergencyroomwheresingleuseishelpfulandtransportationoflargeunitswithcordsand
footpedalsisnotfeasible.

Accu-Temp Cauteries
BeaverVisitec
AccuTempCauteriesaresingleusecauterieswithaoneyearshelflife.
Theyareavailableinavarietyoftipstyles.

Insummary,bipolarelectrocauteryisaveryprecisewaytodeliverheatto
tissuestostopbleedingduringproceduresoraftertraumawhilecausing
minimaltissuedamage.Theunitsdiscussedabovealloffertheirown
AccuTempCauteriesBeaver
advantagesandcanbeusedinavarietyofcapacities.
Visitec

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