Dr. Seibel’s Book

Phacodynamics, Fourth Edition!


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
Dr. Seibel
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Four Editions In Five Languages


Dr. Seibel's Cataract Surgery Textbooks Through the Years and Around the World

Only a small fraction of I% of all doctors are leading experts in their field to the extent of publishing a textbook on their subject of expertise. As rare as this accomplishment is, however, according to medical book publisher John Bond, most books are •one and done•, meaning that it is relatively uncommon for books to be so popular and enduring that they merit a second edition; more than 2 editions are particularly scarce. Similarly, only a small percentage of textbooks are translated into even one other language. Especially uncommon in a major medical textbook is having it authored (and extremely rarely illustrated) by a single physician, as most textbooks of this type are written by many different doctors with the book cover listing the doctor who edited the book.
At four editions, four translations, and sole authorship (and illustrations), Dr. Seibel’s textbook Phacodynamics bas been one of the most unique, popular and important books in the field of modern cataract surgery. With a signature style of illustration and distinctive engineering perspective, it explains the complex technology and principles of cataract surgery in a logical fashion that facilitates Custom Cataract Surgery to provide the safest, gentlest, and most effective operation for each individual patient. According to industry-leading medical publisher SLACK, it is the number one selling cataract surgery textbook in the history of their company, having helped thousands of surgeons to provide better care to millions of patients worldwide.
Textbook Translations


“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 millions of patients world wide. 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


Sample Bookpages

“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

“As in the previous editions, Dr. Seibel demonstrates his unique gift for being able to simplify complex engineering concepts to a clinically understandable and practical level. His signature style of illustration gives us stepwise visual tools to understand what is otherwise happening too rapidly in real time.”

– David F. Chang, M.D.

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.

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  • Machine Technology
  • Logic of Setting Machine Parameters
  • Overview of Phacoemulsification Techniques
  • Irrigation and Aspiration Techniques
  • Physics of Capsulorhexis


  • 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.


  • 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


  • Machine Overview
  • Bimanual Microincision Phaco: Alternate Irrigation Path
  • Foot Pedal
  • Irrigating Bottle


  • 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: 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


  • 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 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

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

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 451/4 IA Tips
  • Bimanual Irrigation and Aspiration
  • Using the IOL to Help Remove Cortex
  • Epinuclear Mobilization via Cortical Pulley
  • 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 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


  • 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