Phaco Foot Pedal Failure

Phacoemulsification and removal of cataracts is controlled not only by the hands of a highly skilled ophthalmological surgeon but by operation of a phaco foot pedal that maintains the delicate fluid dynamics of structures in the eye while performing three critical functions that correspond with three phaco foot pedal positions: (1) irrigation alone, (2) irrigation and aspiration together, and (3) irrigation, aspiration and ultrasound energy delivery. Irrigation, by itself (foot pedal position 1), is critical to assure your eye does not collapse when cataract surgery begins. Irrigation and aspiration together (position 2 – inflow and outflow) maintains the delicate fluid dynamics of intricate structures in the eye after the cataract removal process has begun. Ultrasound delivers power and generates heat as the surgeon chops through the cornea, threads through the iris, macerates the human cataracted lens, and removes/aspirates the debris generated by these processes, including the cataract.

Prior to phacoemulsification surgery, two microscopic stents were injected into the angle of my eye to help lower my intraocular pressure (IOP), which had been elevated by moderate pigmentary glaucoma (eye pressure caused by pigment from the iris sloughing off and clogging the angle – an eye structure that normally allows intraocular fluid to pass through freely). It was actually quite interesting to watch the stent placement “from the inside” as two square windows were cut in the eye to allow the stents to be shot into place. I was looking forward to the main event!

In the midst of my cataract surgery the phaco foot pedal lost power. No alarm was sounded by the phacoemulsification machine. The surgeon calmly announced the foot pedal had stopped. A relatively pain-free process soon became excruciatingly painful. It felt like a finger was being jammed into my eye socket. I gripped the sides of the operating table as tightly as I could and tried to suppress the pain. A scramble ensued among operating room attendees as they sought to find the source of the equipment failure.

Unable to immediately restore power to the foot pedal a technician was sought from outside the operating room. After what felt like an eternity a replacement foot pedal was located, brought to the operating room and pressed into service allowing resumption of fluid dynamic regulation within the delicate structures of eye anatomy. The procedure resumed to conclusion with implantation of an Intra Ocular Lens (IOL).

Questions To Ask Before Singing Cataract Surgery Legal Release Waiver /Assumption of Risk:

Is the phaco foot pedal fully charged?

Is there a backup power supply that kicks in immediately if the phaco foot pedal ceases to function due to loss of battery power?

Is there a plug-in power cord that allows the phacoemulsification process to go forward if the phaco foot pedal loses battery power during the chopping, emulsification and irrigation/aspiration phases of the procedure ? If so, is that backup power cord physically present in the operating room?