Preview

Сибирский научный медицинский журнал

Advanced search

FEATURES OF THE PHACOEMULSIFICATION TECHNIQUE OF CATARACT IN PSEUDOEXFOLIATION SYNDROME

https://doi.org/10.15372/SSMJ20180507

Abstract

Traditional surgery of cataract in pseudoexfoliation syndrome (PEX) can be excessively aggressive and increase zonular instability. The main technological target of this surgery is reducing of a zonular stress at all stages and especially when removing the lens nucleus. Purpose was to develop an effective and safe technique for nucleus removal without rotating crystalline lens during phacoemulsification in PEX. Material and methods. 765 eyes with PEX were treated by phacoemulsification without nuclear rotation using original technique. The left paracentral oblique groove was made after capsulotomy and hydrodissection. Nucleus was divided by phaco tip and chopper. In right heminucleus a lateral deep groove was performed such way to create a big asymmetric wedge including central part of nucleus. This wedge was removed without rude manipulation and rotation. The remaining two peripheral segments were easily gripped and pull into pupil area for safe phacoemulsification. Results. In all cases this technique allowed for safe removing of the nucleus. Cataract surgery was finished without serious intraoperative complications. Conclusion. This method allows reducing intraoperative zonular stress and removing all nucleus fragments in the conditions of limited mydriasis at the maximum distance from the corneal endothelium. The rotationless technology of nucleous removal is effective and safe at cataract in PEX.

About the Author

E. V. Egorova
S. Fyodorov Eye Microsurgery Federal State Institution of Minzdrav of Russia, Novosibirsk Branch
Russian Federation


References

1. Нестеров А.П. Глаукома. 2-е изд. М.: МИА, 2008. 360 с.

2. Тахчиди Х.П., Баринов Э.Ф., Агафонова В.В. Патология глаза при псевдоэксфолиативном синдроме. М.: Офтальмология, 2010. 156 с.

3. Hanemoto T., Kozawa T. Nucleus division without rotation: Umbrella technique // 2014 ASCRS•ASOA Sympsium and Congress: abstr. April 25-29, 2014, Boston. Boston, 2014. http://www.ascrs.org/resources/abstracts/nucleus-division-without-rotation-umbrella-technique.

4. Hyams M., Mathalone N., Herskovitz M., Hod Y., Israeli D., Geyer O. Intraoperative complications of phacoemulsification in eyes with and without pseudoexfoliation // J. Cataract Refract. Surg. 2005. 31. 1002-1005.

5. Jahan F.S., Mamalis N., Crandall A.S. Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients // Ophthalmology. 2001. 108. 1727-1731.

6. Kim D.B. Cross chop: Modified rotationless horizonal chop technique for weak zonules // J. Cataract Refract. Surg. 2009. 35. 1335-1337.

7. Kim D.B. Double-chop: Modified-chop technique eliminating ultrasonic energy and vacuum for lens fragmentation // J. Cataract Refract. Surg. 2016. 42. 1402-1407.

8. Koplin R.S., Anderson J.E., Seedor J.A., Ritterband D.C. In situ nuclear disassembly: Efficient phacoemulsification without nuclear rotation using lateral sweep sculpting and in situ cracking techniques // J. Cataract Refract. Surg. 2009. 35. 1487-1491.

9. Mahdy M.A. Phacoemulsification in cases of pseudoexfoliation using in situ nuclear disassembly without nuclear rotation // Oman J. Ophthalmol. 2012. 5. 83-86.

10. Masket S., Osher R.H. Late complications with intraocular lens dislocation after capsulorhexis in pseudoexfoliation syndrome // J. Cataract Refract. Surg. 2002. 28. 1481-1484.

11. Nagashima R.J. Decreased incidence of capsule complications and vitreous loss during phacoemulsification in eyes with pseudoexfoliation syndrome // J. Cataract Refract. Surg. 2004. 30. 127-131.

12. Nakano C.T., Motta A.F.P., Hida W.T., Nakamura C.M., Tzelikis P.F., Ruiz Alves M., Werner L. Hurricane cortical aspiration technique: One-step continuous circular aspiration maneuver // J. Cataract Refract. Surg. 2014. 40. 514-516.

13. Niżankowska Н.М. Jaskra. Współczesne zasady rozpoznawania. Wrocław: Górnicki Wydawnictwo Medyczne, 2001. 96-101.

14. Pandey S.K., Sharma V. Phacoemulsification in pseudoexfoliation syndrome // DOS Times. 2008. 14. (5). 65-67.

15. Ritch R., Schlotzer-Schrehardt U., Kuchle M. Exfoliation syndrome // Surv. Ophthalmol. 2001. 45. 265-315.

16. Shingleton B.J., Crandall A.S., Ahmed I. Pseudoexfoliation and the cataract surgeon: preoperative, intraoperative, and postoperative issues related to intraocular pressure, cataract and intraocular lenses // J. Cataract Refract. Surg. 2009. 35. 1101-1120.

17. Shingleton B.J., Marvin A.C., Heier J.S., O’Donoghue M.W., Laul A., Wolff B., Rowland A. Pseudoexfoliation: high risk factors for zonule weakness and concurrent vitrectomy during phacoemulsification // J. Cataract Refract. Surg. 2010. 36. 1261-1269.

18. Stephenson M. Keys to managing weak zonules. Review of ophthalmology. Available at: https://www.reviewofophthalmology.com/article/keys-to-managing-weak-zonules

19. Turgut B. To know the indicators and predictors of zonulopathy can prevent the headache of eye surgeon // J. Eye Cataract Surg. 2017. 3. 30.

20. Woodlief N.F., Woodlief J.M. Endocapsular deep-wedge-removal phacofracture // J. Cataract Refract. Surg. 2009. 35. 1656-1658.


Review

For citations:


Egorova E.V. FEATURES OF THE PHACOEMULSIFICATION TECHNIQUE OF CATARACT IN PSEUDOEXFOLIATION SYNDROME. Сибирский научный медицинский журнал. 2018;38(5):45-48. (In Russ.) https://doi.org/10.15372/SSMJ20180507

Views: 456


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2410-2512 (Print)
ISSN 2410-2520 (Online)