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Advantage: Aspiration/Vacuum

#1  
Problem No Vacuum.
Solution
  1. Pinch aspiration line near rear of hand piece. If vacuum rises than problem is in hand piece. Check connections to the hand piece. Check to make sure tip is not clogged.
  2. Check to make sure that the hand piece is not leaking from the rear end.
  3. Check that aspiration plug is pushed in to the vacuum sensor completely and that the O rings on the plug are not damaged.
  4. Check to insure that top valve is closed. (BSS is not dripping from the bottle)
  5. If vacuum does not rise when aspiration line is pinched, check for leaks in the line and for air in the line.
  6. Check pump tubing and gate on pump is closed. Pump tubing should be replaced about every 50 to 100 cases.
  7. Check to see that ART settings are not too low (the secondary flow should not be less than 6 cc/min and the activation point should not be less than 60 mmHg).
Tests
  1. Pinch off the aspiration tubing right behind the aspiration plug and step on the foot pedal. If suction rises to 500, pump and transducer are OK.
  2. Pinch off the aspiration tubing right behind the instrument and step on the foot pedal. If suction rises to 500, administration set is OK.
  3. Occlude aspiration port of the instrument with a rubber glove and step on the foot pedal. If suction rises to 500, instrument is OK.
  4. After suction limit is reached machine should holds suction. If suction cannot be held, machine must be returned for repair.
#2  
Problem Not enough Vacuum.
Solution
  1. Check to make sure vacuum level is high enough to do the procedure. Chopping technique requires at least 250 mm/hg for holding.
  2. Make sure that the tip is not clogged with cataract material or viscoelastic.
  3. Check the sleeve is not worn or over used. A worn sleeve will allow too much irrigation out the front and push material away from the aspiration hole.
  4. Check that the ART is “On” and set correctly.
  5. Check to make sure phaco hand piece is working properly. Poor ultrasound can cause poor aspiration by not emulsifying the material.

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