Phacoemulsification without hydrodissection: Semi-crater and split technique

Soda, Mitsutaka; Yaguchi, Shigeo

doi:10.1016/j.jcrs.2015.05.007

Cited by 8 publications

(3 citation statements)

References 15 publications

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“…Different techniques have been described in the literature to reduce PCR complications in PE surgery. 10 – 13 Considering that the majority of PCR complications develop in PE and I/A stages, it is thought that MWH, which facilitates these phases and reduces PCR complications, is a simple technique that can be easily learned and applied to any cataract, including pseudoexfoliation cataracts, in which pupil is not too dilated, and phacodonesis (except posterior polar cataract).…”

Section: Discussionmentioning

confidence: 99%

Minimal water-jet hydrodissection

Taş¹

2017

OPTH

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This paper presents a hydrodissection technique performed with high-speed pulse injection of only 0.1 cc liquid and assess its efficacy, safety, and the level of reduction in posterior capsule rupture complications in phacoemulsification cataract surgery. The kinetic energy of moving objects is directly proportional to the mass and to the square of its velocity. The high energy obtained by high-speed pulse injection of a small amount of liquid ensures highly effective dissection. Since the amount of liquid is very small, the increase in intraocular pressure and the risk of rupture in the posterior capsule due to anterior capsular block are greatly reduced. More importantly, several rotations of the lens material in the capsule with effective hydrodissection facilitate the phases of phacoemulsification and irrigation/aspiration. As most capsule ruptures occur during these phases, the complication rate is thus reduced.

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Section: Discussionmentioning

confidence: 99%

Minimal water-jet hydrodissection

Taş¹

2017

OPTH

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“…Furthermore, in order to reduce these high-pressure complications, several different methods are now being used instead of the manual-hydro procedure. 18 , 19 In addition, when using the iH technique, cataract surgery can be performed without encountering the potential high pressures that occur during the manual-hydro procedure.…”

Section: Discussionmentioning

confidence: 99%

Irrigation dynamic pressure-assisted hydrodissection during cataract surgery

Masuda

Iwaki²,

Kato

et al. 2017

OPTH

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The irrigation dynamic pressure-assisted hydrodissection technique (irrigation-hydro [iH]) does not require performing manual hydrodissection using a syringe and cannula to achieve cortical-capsular cleavage during cataract surgery. Since the iH technique uses the phaco tip to intentionally vacuum the intraocular fluid in order to induce the irrigation dynamic pressure for cortical-capsular cleavage, there is a reduction in the intraocular pressure (IOP) from the bottle-height-dependent hydrostatic pressure. Thus, since the peak irrigation pressure derived from the phaco tip sleeve will be limited by the height of the irrigation fluid bottle, this is advantageous in helping to avoid excessively high IOP during cortical-capsular hydrodissection. Using this technique, we were able to effectively perform phacoemulsification without complications in 607 of 609 cataract eyes. Our findings show that utilization of the iH technique would be of benefit to patients, as it prevents high-pressure hydrodissection-related complications, such as capsular block syndrome and tears in the anterior hyaloid membrane during cataract surgery.

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“…The procedure was continued using the needle to puncture the capsule in the periphery, extending the tear, gently pushing the peripheral margin with the needle tip until it was parallel to the edge of the pupil, and then tilting the needle to 45° to properly catch and scratch the capsule. Emulsification of the lens nucleus and aspiration of the lens cortex were performed using the semi-crater and split technique [9] with a PEA machine (INFINITI ® Vision System, Alcon, Texas, USA). An acrylic foldable IOL was implanted after the capsular bag was filled with an OVD.…”

Section: Methodsmentioning

confidence: 99%

Objective classification of zonular weakness based on lens movement at the start of capsulorhexis

et al. 2017

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PurposeTo quantify zonular weakness based on lens movement at the start of continuous curvilinear capsulorhexis (CCC) and establish a classification system for it.SettingKozawa Eye Hospital and Diabetes Center, Mito, Japan.DesignRetrospective interventional case series.MethodsWe examined 402 consecutive eyes of 316 patients who underwent CCC, phacoemulsification and aspiration (PEA), and intraocular lens (IOL) implantation. The movement of the lens capsule was measured using images from video recordings of the CCC procedure. Zonular weakness was classified based on the shifted distance: Grade I, less than 0.20 mm; Grade II, 0.20–0.39 mm; and Grade III, greater than 0.40 mm. For each of these grades, we examined the use of the capsule stabilization device during PEA, the surgical procedure for lens removal, and IOL fixation.ResultsWe classified 276 eyes (68.6%) as Grade I, 102 eyes (25.4%) as Grade II, and 24 eyes (6.0%) as Grade III. As the grade increased, the use of the capsule stabilization device in PEA and scleral suture fixation of IOL increased.ConclusionsZonular weakness was quantified by measuring the movement of the lens capsule. An objective classification of zonular weakness based on lens movement may be useful for selecting the appropriate device and procedure during cataract surgery.

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Phacoemulsification without hydrodissection: Semi-crater and split technique

Abstract: Neither author has a financial or proprietary interest in any material or method mentioned.

Cited by 8 publications

References 15 publications

Minimal water-jet hydrodissection

Minimal water-jet hydrodissection

Irrigation dynamic pressure-assisted hydrodissection during cataract surgery

Objective classification of zonular weakness based on lens movement at the start of capsulorhexis

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