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Iris-plane phaco chop: prevention of posterior capsule rupture

Poster Details

First Author: V.Dzinic SERBIA

Co Author(s):    M. Dzinic              

Abstract Details



Purpose:

to show a safe way of division of nucleus in patients with different kind of cataract maturity using phaco-chop technique at the level of the iris plane.

Setting:

Eye Center Dzinic, Vrsacka 34, 21000 Novi Sad Serbia

Methods:

68 eyes (54 patients) undertaken cataract surgery. Mean age was 59±17 years, visual acuity ranges between L+P+ to 0.4 (Snellen chart), and nuclear hardness from N+1 – N +4. Follow up period was 1 year. Phacoemulsification was performed with B&L Millennium using burst mode. /35% fix US, 160ms duration, duty cycle 50%/. In all patients coaxial 2.75mm phacoemulsification technique was performed with temporal approach. After trypan blue capsule dying, capsulorexis and hydro dissection was preformed. By gentle pressing one side of the lens during hydro dissection a part of the equator of the lens was then prolapsed in the anterior chamber at the level of the iris plane. Small amount of viscoelastic was introduced in anterior chamber to protect endothelial cells and under the equator of the lens to displace the bag. Chopper is than introduced through the side port behind the lens to support it and first phaco-chop was preformed. The lens was divided in two parts. By holding the chopper behind and rotating the lens, nucleus is chopped into small pieces and then emulsified. Aspiration of cortical materials and in the bag implantation was performed. In all eyes single piece hydrophilic acrylic lenses were implanted.

Results:

In all patients successful cataract removal was achieved without posterior capsule rupture. Resolution of corneal edema after the surgery depended from cataract maturity and varies from 2-10 days. In all patients corneal edema was completely resolved at the follow up visit on the 10th day after the surgery. Best corrected visual acuity in all patients were between 0.8 and 1.0 and corneas remain stable and clear during follow up period.

Conclusions:

The first division of the nucleus is usually the hardest. In the bag maneuvers raises the chance of posterior capsule rupture, especially in younger and inexperienced surgeons. This study shows that nuclear division and chopping at the level of iris plane is safe and useful technique in preventing posterior capsule rupture. Despite the fact that phacoemulsification and chopping maneuvers were done closer to the endothelial cells all cornea remains clear during follow up period. FINANCIAL DISCLOSURE?: No

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