Ординатура / Офтальмология / Английские материалы / The Art of Phacoemulsification_Mehta, Alpar_2001

Limbal incision 64 clear corneal 65

advantages 65

evaluating limbal versus clear corneal 65 incision design 66

incision shape 66

Langerman hinge and Gills modification 67 posterior 64

scleral incisions 70

superolateral incisions 71 Limbus vs clear cornea 74

Agarwal karate chop technique 77 cortical washing 82

foldable IOL implantation 82 hydrodissection 79

incision 77

pad, S/C injections 83 pulse phaco 81

rhexis 78

stromal hydration 82 two halves 79

phaco chop technique 76 introduced by Dr Nagahara 76

Local anesthesia 51 agents 52

injectable 52 topical 52

alternative methods 55 peribulbar 56 retrobulbar 56 sub-Tenon’s 56 topical 56

mechanism of action 51 techniques 52

peribulbar injection 54 retrobulbar injection 53

Loop lenses 293 optical zones of 293

M

Magnetostrictive mechanism 32 Mature hard nucleus 236 Mature white cataract 237

Modified phacoemulsification in situ 204 Multiport phaco tip 471

a new teaching tool 476 advantages of 475 availability 477

design 474 function 474 functions of 472 problems with

blockage of the bore 472 inadvertent capsular contact 472

N

Nagahara chopper 158 Nd: YAG laser 101

role of 101 Nuclei

dense 182, 183 soft 181

Nucleus removal 139, 180, 220

combined glaucoma and cataract surgery 146

emulsification 140

enlargement of the pupil 145 small pupil 145

technique for hard nuclei 143 technique for medium hard nuclei 140

O

Operating room

requirements and necessities 1 air-conditioning and ventilation 2 autoclave 4

electrical power 3 footwear use 11 lighting 2

noise level 3

operating microscope 7 operating table 5 personnel 4

power generators 3 scrubbing facilities 4 surgical chair 6

P

Peribulbar anesthesia 131 Peristaltic 487

Peristaltic pump 22, 33 advantages of 22 disadvantages of 23

Petalloid phacoemulsification 209 technique 209

Phaco machines in use Alcon legacy 131

Allergan AMO prestige 131 Allergan AMO sovereign 131 tips and sleeves 132

Phaco needles 48 transient cavitation 48

Phaco slice and separate 154 method 155

hydrodissection 155 Phaco tip 17

phaco power settings 18 Phaco transducers 46

basics of 46

Phaco-trabeculectomy 327 Phacoemulsification 1, 223, 239, 240, 384,

complications at various phases of 395 clear corneal incision 396

during capsulorrhexis 398

problem with side port incision 397 endoscopy-assisted 500

in difficult cases 223 in white cataracts 214 management 216

capsulotomy 217

surgical considerations 217 modern nucleofractis techniques 118

four-quadrant cracking 118 stop and chop 119

morphological classification 214 type A 214

type B 215 type C 215

prevention of complications 399 problems of the nucleus 402 problems with nucleofractis 402 rupture of the posterior capsule 400 with hydrodissection 399

preventive aspects 393 aspiration of excess fluid 395

checking the intraocular pressure 394 fresh air under the drapes 394 placement of the lid retractor 395

quadrantic cracking, chopping and stuffing technique 120

central debulking and pregrooving 120 cracking 124

epinucleus removal 128 preliminary steps 120 segment removal 124

reasons for 214 Phacoemulsification before trephination

tripple procedure with 462 advantages 462

Phacoemulsification technique 196 Phacoendoscopy 501 Phacomachine 15, 29

auditory feedbacks cause 30 mode 30 sound 30

basic features

irrigation handpiece 15 irrigation-aspiration handpiece 15 magnetorestrictive handpiece 17 ultrasonic handpiece 16

essential of 29

Phakonit 446 principle 447 technique 447

hydrodissection 448 incision 448

rhexis 448 terminology 447

Physical endothelial cell protection

hema intracameral endothelial contact lens 373 design of the hema hood 374

insertion of the hood 374 material of the hema hood 374 phacoemulsification 375 preparation of the hood 374 removal of the hood 375

Physics of phaco 25 irrigation 26 pump flow 25 rise time 25

Piezoelectric effect 32 Plate lens

accommodating 288

Chiron vision 4203 and C10 289 mini-loop 288

modified 288

STAAR surgical 404 288 Polishers

diamond impregnated 408 ultrasound 408

vacuum capsule 408

Posterior capsular rupture 184, 249, 409 causes for 409

management 410

with hyaloid face rupture 411, 413 without hyaloid face rupture 410

recognition of 249 signs of 409

Posterior capsulorrhexis special techniques 110

diathermy capsulotomy 111 tryphan blue staining 110

Posterior capsulotomy 407 intraoperative primary 407

Posterior chamber IOL capture management of 415 surgical technique for 417

complications in the surgery 420 treatment of 417

types of 416

with posterior synechiae 416 without posterior synechiae 416

Posterior implantation 502 endoscopy of 502

Postvitrectomy 173 Postvitrectomy patients 244 Preferred phacoemulsifier 189 Previously filtered eye

bleb revision techniques external bleb revision 340

hypotony maculopathy 342 phacoemulsification in 329 postoperative considerations 337

preoperative considerations 332 special considerations 332 surgical approaches 331

Pseudoexfoliation 174 syndrome 240 technique 381

Pupil enlarging surgery 227 Pupil stretching devices 231 Pupil stretching techniques 231 Pupilloplasty 228

stretch 171, 314 technical tips 315

S

Scleral fixation 423, 428, 433, 436, 441, 443 complications in 443

corneal decompensation 444 cystoid macular edema 444 endophthalmitis 444

fixation of the root of the iris 444 glaucoma 443

hyphemas and vitreous hemorrhages 444 IOL tilt 443

retinal detachment 444 Flieringa ring in 428 incision in 433

limbal 434 tunnel 434

intraocular lenses adapted for 424 “J”-type 424

AcrySof lens 425 Durval’s IOL 424

with ring on the haptic 424 IOL placement in 436

monitoring of 436 positioning of 437

limbal incision suture 439 suture fixation 438 sutures used in 425

10-0 polypropylene 425

10-0 prolene 425

9-0 polypropylene 425 vitrectomy in 441

Scroll pump 33

Side port incisions 36

Silicone IOLs 256 two types of 256

one-piece plate design 256 three-piece open loop designs 256

Sinus fracture and intranuclear nucleotomy technique 211

Slit nucleotomy 213 Small pupil 170, 226

Small-incision cataract surgery 58 ocular anesthesia for 58

other methods 60 topical anesthesia 59 traditional methods 58

Snap and split phaco 154

Society of cataract and refractive surgery 49 Soft cataracts 84

Sphincterotomies 171

Stable intraocular environment 35 String of pearls 102

Stromal hydration 449 Subincisional cortex removal

techniques for 250 bimanual technique 250

ice-cream scoop maneuver 250 Subluxated lens 172

Surge suppression system 9

Surgeon’s requirements during the procedure 33 Surgical design “Ocusystem” 36, 41

sophisticated foot pedals 41 sophisticated microprocessors 43

“Sovereign” machines 43 AMO “Diplomax” 43

Sutherland scissors 232

T

Tactile feedback 29

Topical anesthesia cataract surgery 84 Topical/intracameral anesthesia 61

advantages of 61 contraindications 61

Toric IOLs 257

Trabeculectomy instruments 146 technique 146 white cataracts 147

Transscleral needle pass 432 Traumatic cataract 242

U

Uveitis 172

V

Vacuum-based pumps 33 FAVIT technique 487 rotary vane 33