The CataRhex 3®, engineered by Oertli Instrumente AG, is a portable, high-performance surgical platform designed to deliver precise fluidic control, efficient emulsification, and versatility across multiple anterior segment procedures. Despite its footprint (≈5 kg), it integrates proprietary technologies—SPEEP®, easyPhaco®, and HFDS®—that empower surgeons to operate with uncompromising safety, efficiency, and mobility. In this article, we take an in-depth look at its technology, clinical evidence, applications, surgeon benefits, and practical considerations.
1. Manufacturer Overview: Oertli Instrumente AG
Oertli is a Swiss family-owned company founded in 1955, headquartered in Berneck (Canton of St. Gallen). Over the decades, it has become a global benchmark in equipment and instruments for ophthalmic surgery. Developing and manufacturing the vast majority of its solutions in Switzerland, Oertli places a strong emphasis on precision, reliability, and user-centric design. In 2024, the company was honored with the Swiss Medtech Award, recognizing its outstanding track record of innovation and performance in the medtech sector.
2. Concept and Positioning of the CataRhex 3
The CataRhex 3 was born from the vision of packing comprehensive capabilities for cataract surgery, MIGS glaucoma procedures, and anterior vitrectomy into an extremely compact platform. Weighing approximately 5 kg, it achieves this without compromising on powerful fluidics or energy control. It is purpose-built for operating rooms with limited space, mobile surgical units, humanitarian missions, and surgical centers requiring top-tier performance coupled with effortless transportability.
3. Differential Technology — SPEEP®: Independent Control of Flow and Vacuum
The most disruptive element of the CataRhex 3 is the SPEEP® pump. It seamlessly merges the principles of a peristaltic pump for flow control with the dynamic responsiveness of a Venturi system for vacuum. This allows the surgeon to regulate flow and vacuum independently and precisely adjust the "holding force" at the instrument tip—even via the foot pedal—maintaining absolute control during occlusions. In clinical practice, SPEEP delivers an immediate, finely dosed response during delicate maneuvers, such as managing Intraoperative Floppy Iris Syndrome (IFIS) or zonular weakness.
4. easyPhaco® — Fluidics Philosophy Applied to Phacoemulsification
The easyPhaco® technology relies on a fluidics concept that promotes a "magnet-like" attraction to the tip (easyTip), exceptionally high fragment holding force, and a broad infusion channel that ensures a remarkably stable anterior chamber. The result is highly controlled emulsification where ultrasonic energy is directed primarily at the occluded fragment, drastically reducing efficiency loss and the risk of turbulence. The easyTips are available in optimized sizes for both CO-MICS and MICS techniques (1.6–3.2 mm).
5. High-Frequency Capsulotomy and Bipolar Diathermy
The CataRhex 3 features a High-Frequency (HF) capsulotomy function that allows surgeons to open the anterior capsule using localized diathermy, eliminating the need for a classic mechanical tear. This is particularly advantageous in cases of hypermature cataracts, ocular trauma, small pupils, or situations where controlling the capsular flap is highly complex. The unit also supports additional HF applications, including specialized manipulations for MIGS.
6. Integrated Anterior Vitrectomy
The platform comes equipped with a built-in compressor for anterior vitrectomy and utilizes a pneumatically driven, continuous-flow guillotine cutter capable of reaching up to ~2,400 cuts/minute, this delivers highly effective vitrectomy with minimal vitreoretinal traction. The integrated compressor entirely eliminates the need for an external air supply—a critical advantage for mobile operating rooms or resource-limited environments.
7. HFDS® — Implant-Free Ab Interno MIGS
Oertli incorporates its proprietary HFDS (High-Frequency Deep Sclerotomy) technology into the CataRhex 3 to enable implant-free ab interno MIGS procedures. Published studies demonstrate a sustained reduction in intraocular pressure (IOP) following combined HFDS and cataract surgery, showcasing highly favorable long-term outcomes (e.g., case series with a 48-month follow-up report significant IOP reduction and a high percentage of qualified successes). The technique utilizes high-frequency energy to create micro-sclerotomies, effectively enhancing aqueous humor outflow.
8. Ergonomics, User Interface, and Foot Pedal
The CataRhex 3 offers a clean, customizable control interface capable of storing up to 20 user profiles. It features color-coded front connections, an adjustable display, and a robust, linear, water-resistant foot pedal (IPX6 rating). The pedal provides fine linear control, direct access to memory settings, and swift function activation, utilizing wired transmission to guarantee uninterrupted signal stability. All these elements are designed to minimize the learning curve and facilitate highly reproducible surgical workflows.
9. Intraoperative Safety and Consumable Design
- EasyTips: Angled tips with a wide internal channel designed for continuous holding and steady aspiration.
- I/A Safety Design: Quick Tips featuring an elongated shaft and a strategically positioned opening to significantly reduce inadvertent capsule capture.
- Tubing System Outfitted with an integrated pressure sensor and automatic purging to ensure maximum fluidic safety.
These specific features drastically reduce the risks of anterior chamber collapse, accidental capsular aspiration, and complications related to IOP fluctuations.
10. Clinical Evidence and Publications
A robust body of literature supports the core concepts integrated into the CataRhex 3. Studies on HFDS consistently demonstrate the efficacy and safety of the technique with long-term follow-up (48 months) and excellent IOP reduction. Furthermore, numerous articles and clinical presentations highlight the practical advantages of SPEEP fluidics and the easyPhaco approach regarding precise fragment control and chamber stability. While many series stem from manufacturer data and collaborating centers, the reviewed bibliography is highly encouraging and strongly supports its adoption by trained professionals.
11. Ideal Use Cases and Target Users
- Surgeons operating in space-constrained environments (mobile clinics, outreach campaigns, satellite hospitals).
- High-volume phacoemulsification centers that prioritize speed, reproducibility, and uncompromising fluidic control.
- Surgeons regularly performing combined Cataract + MIGS procedures.
- Surgical teams requiring occasional anterior vitrectomy capabilities without the need to invest in standalone external systems.
12. Competitive Advantages at a Glance
- Ultra-Portability: A highly compact unit ready for operation in seconds.
- Advanced Fluidics (SPEEP): True independent control of flow and vacuum.
- Efficient Emulsification (easyPhaco): Paired with purpose-built easyTips for superior holding power and aspiration.
- All-in-One Integration: Seamless inclusion of MIGS (HFDS) and anterior vitrectomy without relying on external equipment.
- User-Centric Design: Backed by a renowned Swiss manufacturer with a long-standing tradition of engineering excellence.
13. Practical Considerations for Adoption
- Training: While the interface is highly intuitive, optimal utilization requires specific training in SPEEP dynamics and modulation modes (Linear / Pulse / Burst), as well as hands-on practice with easyTips. Oertli provides comprehensive educational resources and instructional videos to support this transition.
- Consumable Compatibility: It is recommended to verify the local availability of easyTips, HF capsulotomy tips, and pressure-sensor tubing sets.
- Maintenance and Service: As a premium Swiss manufacturer, Oertli maintains a robust regional distribution and support network. Facilities should confirm service turnaround times and spare parts availability with their designated local distributor.
The CataRhex 3 represents a coherent, modern technical commitment to bringing capabilities that once required much larger machines into any operating room—even mobile ones. Its unique integration of SPEEP® (advanced fluidic control), easyPhaco® (fluidics-driven emulsification), HF capsulotomy, HFDS for MIGS, and built-in anterior vitrectomy makes it an incredibly versatile platform for the modern anterior segment surgeon. Backed by Oertli's Swiss manufacturing heritage and published clinical studies on its key components, the CataRhex 3 stands as a definitive choice for institutions seeking top-tier performance, ultra-portability, and a design engineered for real-world clinical excellence.
Selected References
- SPEEP / CataRhex 3 Overview — Oertli Instrumente AG.
- easyPhaco Technology — Oertli Instrumente AG.
- HFDS (High-Frequency Deep Sclerotomy) — Clinical studies and 48-month follow-up data.
- CataRhex 3 — Official product datasheet and brochure.
- About Oertli — Company history and industry recognition (Swiss Medtech Award 2024).