-
European Journal of Ophthalmology Jan 2020We describe a technique for performing hydrodissection in which the cannula tip is not advanced beyond the capsulorhexis edge, nor embedded into the cortex, but instead...
We describe a technique for performing hydrodissection in which the cannula tip is not advanced beyond the capsulorhexis edge, nor embedded into the cortex, but instead is placed within the capsulorhexis boundaries, pointing to the capsulorhexis edge, and angled slightly posterior to it. The fluid stream squirted from the cannula creates a cleavage plane between the capsule and cortex (hydrodissection), with a distinct wave dissecting the posterior capsule off the overlying cortex. By later rotating the angle slightly more posteriorly, hydrodelineation occurs, with the resultant "golden ring," and often, multiple "golden rings." The cleavage planes obtained using this technique may be more precise than when embedding the cannula tip under and beyond the capsulorhexis edge. This "remote hydrodissection" technique is easy and reproducible with soft and medium lenses, becoming more difficult to perform with harder cataracts. Hence, we recommend that this modification should initially be learned/tried on softer lenses.
Topics: Capsulorhexis; Catheterization; Humans; Phacoemulsification; Robotic Surgical Procedures
PubMed: 30722695
DOI: 10.1177/1120672119827774 -
Journal of Cataract and Refractive... Sep 2014Improvements in phacoemulsification technology and instrumentation and intraocular lens materials and design have enabled cataract surgery to be performed through... (Review)
Review
UNLABELLED
Improvements in phacoemulsification technology and instrumentation and intraocular lens materials and design have enabled cataract surgery to be performed through incisions smaller than 2.0 mm in external width. This evolution has occurred over time, with new challenges arising at each step of the decrease in incision size. This article reviews the current trend of using increasingly smaller incisions to perform phacoemulsification. Specifically, each facet of phacoemulsification is briefly reviewed from a historical context and then evaluated predominantly from a current perspective to better understand the development of the microincision in cataract surgery. The goal is to help the operating surgeon recognize the potential benefits as well as the potential weaknesses of the smaller incision.
FINANCIAL DISCLOSURES
Proprietary or commercial disclosures are listed after the references.
Topics: Astigmatism; Capsulorhexis; Cataract; Cornea; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Microsurgery; Phacoemulsification; Prosthesis Design; Sclera; Wound Healing
PubMed: 25135548
DOI: 10.1016/j.jcrs.2014.07.006 -
Indian Journal of Ophthalmology Dec 2017Phacoemulsification is the most commonly performed cataract surgery in this era. With all the recent advances in investigations and management of cataract through... (Review)
Review
Phacoemulsification is the most commonly performed cataract surgery in this era. With all the recent advances in investigations and management of cataract through phacoemulsification, most of the patients are able to achieve excellent visual outcome. Corneal edema after phacoemulsification in the immediate postoperative period often leads to patient dissatisfaction and worsening of outcome. Delayed onset corneal edema often warrants endothelial keratoplasty. This review highlights the etiopathogenesis, risk factors, and management of corneal edema in the acute phase including descemet's membrane detachment (DMD) and toxic anterior segment syndrome. Various investigative modalities such as pachymetry, specular microscopy, anterior segment optical coherence tomography, and confocal microscopy have been discussed briefly.
Topics: Corneal Edema; Humans; Phacoemulsification; Postoperative Complications
PubMed: 29208818
DOI: 10.4103/ijo.IJO_871_17 -
Arquivos Brasileiros de Oftalmologia 2023
Topics: Humans; Phacoemulsification; Cataract Extraction; Internship and Residency; Teaching
PubMed: 37878952
DOI: 10.5935/0004-2749.2023-1005 -
Journal of Cataract and Refractive... Jan 2019The treatment of choice for cases of corneal opacity with significant cataract is often a triple procedure. However, in certain situations the chances of graft survival... (Review)
Review
The treatment of choice for cases of corneal opacity with significant cataract is often a triple procedure. However, in certain situations the chances of graft survival are poor, for example in cases with deep vascularization, secondary glaucoma, and healed viral keratitis. Under these circumstances, performing cataract surgery only might improve the visual acuity enough to maintain the patient's day-to-day activities. Performing cataract surgery, especially phacoemulsification, in these cases is challenging. Proper case selection, choosing the right technique, and a thorough idea about the difficulties and methods of tackling such cases is paramount to achieving optimum visual outcomes. In this review, we discuss the case selection and surgical modifications of performing phacoemulsification in cases with coexisting corneal opacities.
Topics: Cataract; Corneal Opacity; Humans; Phacoemulsification; Visual Acuity
PubMed: 30509744
DOI: 10.1016/j.jcrs.2018.09.015 -
Current Opinion in Ophthalmology Jan 2017The purpose is to review the current and effective advantages of femtosecond laser-assisted cataract surgery (FLACS). (Review)
Review
PURPOSE OF REVIEW
The purpose is to review the current and effective advantages of femtosecond laser-assisted cataract surgery (FLACS).
RECENT FINDINGS
FLACS has advantages over manual phacoemulsification in its precision, and predictability and may be especially advantageous in difficult situations such as shallow anterior chamber, subluxated cataracts, white cataracts, and so on. However, the femtosecond capsulorhexis may not be as strong as a manual rhexis. Laser-induced miosis is also a potential disadvantage.
SUMMARY
There may be increased surgeon confidence and patient satisfaction with FLACS and it may be friendlier to the internal structures of the eye. However, it is not superior to manual phacoemulsification in terms of primary outcomes such as visual and refractive outcomes or overall complications. Further refinements in technology may be needed to give it distinct advantages over manual phacoemulsification and to make it the norm in cataract surgery.
Topics: Capsulorhexis; Humans; Intraoperative Complications; Laser Therapy; Phacoemulsification; Refraction, Ocular; Visual Acuity
PubMed: 27801688
DOI: 10.1097/ICU.0000000000000333 -
Indian Journal of Ophthalmology Jan 2020
Topics: Adult; Cataract; Humans; Lens, Crystalline; Male; Phacoemulsification; Visual Acuity
PubMed: 31856523
DOI: 10.4103/ijo.IJO_1214_19 -
Indian Journal of Ophthalmology Oct 2018
Topics: Cataract; Humans; Infant; Lens, Crystalline; Male; Phacoemulsification; Visual Acuity
PubMed: 30249841
DOI: 10.4103/ijo.IJO_637_18 -
Current Opinion in Ophthalmology Jan 2019This review aims to introduce recent updates in cataract surgery and lens implantation. (Review)
Review
PURPOSE OF REVIEW
This review aims to introduce recent updates in cataract surgery and lens implantation.
RECENT FINDINGS
Compared to phacoemulsification, femtosecond laser-assisted cataract surgery (FLACS) may offer benefit for cataract patients with other complicated ocular diseases, such as corneal disease and vitreous abnormalities. Meanwhile, several types of novel intraocular lenses (IOLs) have been introduced to the market, and each of them has particular features in improving patients' visual acuity. In addition, based on a series of studies, multifocal IOL is superior to monofocal IOL when it comes to providing a better visual correction at different distances. Furthermore, a research group has introduced a new approach for cataract surgery - all laser surgery (FLACS band with nanolaser emulsification), which can effectively reduce iatrogenic trauma to the cornea. Also, a novel technique designed for children can lessen damage from cataract surgery.
SUMMARY
Based on previous studies, we summarize the new proceedings in FLACS and the indications for applying multifocal or toric IOL. In addition, we briefly introduce a new approach to cataract surgery - all laser surgery (FLACS band with nanolaser emulsification), and a less invasive surgical procedure used in pediatric cataract patients.
Topics: Humans; Laser Therapy; Lens Implantation, Intraocular; Lens, Crystalline; Lenses, Intraocular; Multifocal Intraocular Lenses; Phacoemulsification; Visual Acuity
PubMed: 30335627
DOI: 10.1097/ICU.0000000000000547 -
The Pan African Medical Journal 2017Cataract is a total or partial clouding of the lens of the eye. It can be congenital or acquired. Cataract associated with the aging process (senile) is the most common...
Cataract is a total or partial clouding of the lens of the eye. It can be congenital or acquired. Cataract associated with the aging process (senile) is the most common type. Common symptoms include visual impairment which varies based on the type and the density of lens opacity. Cataracts etiology is varied and treatment is based on surgery. In patients with morgagnian cataract cortex liquefies and lens core hardens and becomes cloudy. We here report the case of a 51-year old patient with no notable medical history presenting with progressive decreased visual acuity in the left eye with no pain or redness of the eye associated. Ophthalmologic examination showed visual acuity (the individual can see hand movement), clear cornea, normal anterior chamber depth, an intraocular pressure of 15 mmgh and morgagnian cataract. The patient underwent phacoemulsification cataract surgery with implantation within the capsular bag. Post-operative suites were simple.
Topics: Cataract; Humans; Male; Middle Aged; Phacoemulsification; Visual Acuity
PubMed: 29515742
DOI: 10.11604/pamj.2017.28.124.13213