Closed chamber globe stabilization and needle capsulorhexis using irrigation hand piece of bimanual irrigation and aspiration system

Abstract

BackgroundThe prerequisites for a good capsulorhexis include a deep, well maintained anterior chamber, globe stabilization and globe manipulation. This helps to achieve a capsulorhexis of optimal size, shape and obtain the best possible position for a red glow under retroillumination. We report the use of irrigation handpiece of bimanual irrigation aspiration system to stabilize the globe, maintain a deep anterior chamber and manipulate the globe to a position of optimal red reflex during needle capsulorhexis in phacoemulsification.MethodsTwo side ports are made with 20 G MVR 'V' lance knife (Alcon, USA). The irrigation handpiece with irrigation on is introduced into the anterior chamber through one side port and the 26-G cystitome (made from 26-G needle) is introduced through the other. The capsolurhexis is completed with the needle.ResultsNeedle capsulorhexis with this technique was used in 30 cases of uncomplicated immature senile cataracts. 10 cases were done under peribulbar anaesthesia and 20 under topical anaesthesia. A complete capsulorhexis was achieved in all cases.ConclusionThe irrigating handpiece maintains deep anterior chamber, stabilizes the globe, facilitates pupillary dilatation, and helps in maintaining the eye in the position with optimal red reflex during needle capsulorhexis. This technique is a safe and effective way to perform needle capsulorhexis.

Capsulorhexis Under Continuous Fluid Pressure in Intumescent Cataracts: A New Technique

“…To our knowledge, there is no other study other than our study in which capsulorhexis was performed with maintainer under continuous uid pressure in intumescent cataracts. In a study by Sethi et al [34], capsulorhexis was performed with a cystotome using an irrigation probe in immature cataracts. Öksüz et al [29] performed vacuum-assisted capsulorhexis with an aspiration probe while providing anterior chamber stabilization with an irrigation probe in immature cataracts.…”

<p>Closed-Chamber Anterior Capsulorhexis Under Air Tamponade In White Cataract</p>

“…Each technique has its drawbacks and may not be suitable for all surgeons. The use of viscoelastics,10 or a cannula attached to the infusion bottle raised high enough to give adequate depth to the AC is a common surgical practice 11…”

Vacuum-Assisted Continuous Circular Capsulorhexis Using Bimanual Irrigation and Aspiration System of Phaco Machine in Immature Cataract

“…The CCC is one of the prerequisites for successful phacoemulsification. When performing CCC surgeons use either viscoelastics and forceps or a needle connected to the infusion bottle raised high enough to give adequate depth [ 2 – 4 ]. In our technique, we prefer to use irrigation hand piece to achieve well maintained deep anterior chamber and relaxed zonules throughout the capsulorhexis.…”

“…Sethi et al performed CCC with the anterior chamber maintainer using cystotome [ 4 ]. Performing CCC with such a method causes capsular flap waving due to irrigation.…”

“…CCC can be performed in several ways. It can be performed using cystotome, small incision capsulorhexis forceps, or utrata forceps [ 1 – 4 ]. When we perform CCC with these tools we use ophthalmic viscosurgical devices (OVDs).…”