Posters

Two fibre-cross techniques for supporting lens with insufficient zonula during phacoemulsification

Poster Details

First Author: P.Bulir CZECH REPUBLIC

Co Author(s):                        

Abstract Details

Purpose:

There is several techniques used during complicated cataract surgery for supporting crystalline lens with insufficient zonula. Many techniques are based on anterior segment approach. Our new technique is based on inserting two nylon fibres in cross manner stretching from one scleral pars plana input to opposite pars plana output. This support can be  easily and fast done and ready for  lenses with very severe zonulolysis offering  strong and save fixation during phacoemulsification. There is almost no chance for dislocation of lens to vitreous cavity.

Setting:

Department of Ophthalmology , Hospital Liberec, Czech Republic

Methods:

This technique is based on inserting stretched nylon fibres from one to another pars plana location. The first and the second pars plana sutureless ports on trokar is inserted in position 6-12. With two Eckhart forceps is stretched  nylon 10/0 fibre from one to the opposite  port and keeping unstable lens i place.  Ports can be than removed, and fiber stays in place. Removed ports can than be used again the same way in 90 degrees angle position and the second fiber is then crossing the first fiber . Fibers can be very easily removed at the end of surgery.

Results:

This technique crystalline lens support during phacoemulsification showed excellent stability, during whole surgery.  No dislocation of  lens and no complication due to pars plana insertion or extraction was observed.  This technique can be used not only for crystalline lens support but also for temporary support during IOL scleral fixation.

Conclusions:

Weak zonula or large zonulolysis are always big challenge even for experienced surgeon. There is described several supporting techniques keeping crystalline lens in anterior segment in order to avoid dislocation of  the lens in vitreous cavity. Using conventional capsular hooks is quite dependent on fluidics fluctuation and can easily slide off . It can be used also  just on partial zonulolysis not by large defects.  This technique provides stable support also in large defects and is not dependent on fluidics instability.

Financial Disclosure:

None