Index

Phacoemulsification Surgery Rasik B Vajpayee, Namrata Sharma, Suresh K Pandey, Jeewan S Titiyal

SECTION 1: ANATOMICAL AND PREOPERATIVE CONSIDERATIONS
CHAPTER 1:Evolution of Phacoemulsification
CHAPTER 2:Anatomy of Crystalline Lens, Capsular Bag and Zonules
- ANATOMY-HISTOLOGY OF THE HUMAN CRYSTALLINE LENS
- GROWTH OF THE HUMAN CRYSTALLINE LENS
- LENS CAPSULE
- LENS EPITHELIAL CELLS
- LENS SUBSTANCE (CORTEX AND NUCLEUS)
- ACKNOWLEDGEMENT
CHAPTER 3:Preoperative Evaluation for Phacoemulsification Surgery
- INTRODUCTION
- PREOPERATIVE ASSESSMENT
SECTION 2: ADJUNCTS IN PHACOEMULSIFICATION
CHAPTER 4:Intraocular Lens Power Calculation and Ocular Biometry
- INTRODUCTION
- BIOMETRY
  - Axial Length
    - Axial Length Instruments
    - Immersion Technique
  - Ultrasound Velocities
- CORNEAL POWER
- IOL POSITION
- FORMULAS
  - GENERATIONS
  - Refraction Formula
- USAGE
  - Based on Axial Length
  - Methodology
- PERSONALIZATION
- CLINICAL VARIABLES
  - Patient Needs and Desires
- SPECIAL CIRCUMSTANCES
- CONCLUSION
CHAPTER 5:Ophthalmic Viscosurgical Devices and Phacoemulsification Surgery: Classification, Surgical Applications and Complications
- CLASSIFICATION OF THE OVDs
  - High Viscous-cohesive OVDs
- SURGICAL APPLICATION OF THE OVDs
- COMPLICATIONS ASSOCIATED WITH OVDs
- SUMMARY AND CONCLUSIONS
  - Acknowledgement
CHAPTER 6:Surgical Pharmacology: Intraocular Solutions, Medications and Instruments
- IRRIGATING SOLUTIONS
  - Inorganic Ions
- ORGANIC SUBSTANCES
  - pH and Osmolality
  - Evolution of Modern Irrigating Solutions (Table 6.2)
- OCULAR MEDICATIONS
- SUMMARY
CHAPTER 7:Intracameral Drugs DuringPhacoemulsification
CHAPTER 8:Sterilization of Operation Theatre and Surgical Equipments
- INTRODUCTION
SECTION 3: PHACOEMULSIFICATION: THE SURGICAL TECHNIQUE
CHAPTER 9:Anesthesia
CHAPTER 10:Wound Construction
- INTRODUCTION
- TYPES OF INCISION
- CONTROLLING ASTIGMATISM DURING PHACOEMULSIFICATION
CHAPTER 11:Continuous Curvilinear Capsulorhexis
- INTRODUCTION
CHAPTER 12:Anterior Capsule Staining During Phacoemulsification
CHAPTER 13:Hydroprocedures
- INTRODUCTION
- SURGICAL ANATOMY OF THE CRYSTALLINE LENS
- HYDRODISSECTION
  - Conventional Hydrodissection
  - Cortical Cleavage Hydrodissection
- HYDRODELINEATION
- HYDRODELINEATION
- COMPLICATIONS DURING HYDROMANEUVERS
CHAPTER 14:Phacodynamics and Machines
- INTRODUCTION
- ULTRASONIC HANDPIECE
  - Magnetorestrictive Transducers
  - Piezoelectric Transducers
- PHACO NEEDLE (TIP) DESIGN
- MECHANISMS OF NUCLEAR EMULSIFICATION
- IRRIGATION-ASPIRATION (IA) HANDPIECE
- ASPIRATION PUMPS
- FEW PROTOTYPE MACHINES
- BAUSCH AND LOMB SURGICAL MILLENNIUM PHACOEMULSIFIER
  - Ultrasound and Tip
  - Fluid Dynamics
- BAUSCH AND LOMB SURGICAL CATALYST
  - Fluid Dynamics
  - Ultrasound and Tip
- ALLERGAN MEDICAL OPTICS (AMO) DIPLOMAX
CHAPTER 15:Ancillary Instruments for Phacoemulsification
- RAW MATERIAL USAGE
- INSTRUMENTS USED FOR INCISION AND WOUND CONSTRUCTION
- INSTRUMENTS USED FOR CAPSULOTOMY
  - Cystitome
  - Forceps
- INSTRUMENTS FOR HYDROPROCEDURES
- INSTRUMENTS TO MANIPULATE AND CHOP THE NUCLEUS
  - Manipulators
  - Choppers
- INSTRUMENTS USED FOR ASPIRATION OF RESIDUAL CORTEX
  - J-shaped or U-shaped I-A cannulas
  - Bimanual I and A Cannulas8,9 (Fig. 15.8)
- INSTRUMENTS FOR FOLDABLE LENS INSERTION
CHAPTER 16:Basic Techniques of Nuclear Emulsification
- INTRODUCTION
- TRENCH DIVIDE AND CONQUER (TDC) NUCLEOFRACTIS
  - Employed in Soft to Moderately Hard Nuclei
  - Downslope Sculpting
- MULTIDIRECTIONAL DIVIDE AND CONQUER (MDC)
- CRATER DIVIDE AND CONQUER (CDC)
  - Employed in Moderately Hard to Very Hard and Even Dense, Brunescent Nuclei
    - Phaco Sweep
- POLAR EXPEDITIONS
  - Challenges of Phaco: The Small Pupil
  - Challenges of Phaco: Intumescent lens
CHAPTER 17:Advanced Techniques for Nuclear Emulsification
- CHOPPING TECHNIQUES
- KARATE CHOP
  - Principle
  - Technique
- STOP AND CHOP
  - Principle
  - Technique
- CRATER AND CHOP
  - Principle
  - Technique
- FOUR QUADRANT NUCLEAR FRACTURE IN SITU
  - Principle
  - Techniques
- MODIFIED PHACOEMULSIFICATION IN SITU
  - Principle
  - Technique
- PETALLOID NUCLEOTOMY
  - Principle
  - Technique
- SINUS FRACTURE
  - Principle
  - Technique
- INTRANUCLEAR NUCLEOTOMY
- CHIP AND FLIP TECHNIQUE
  - Principle
  - Technique
- SUPRACAPSULAR NUCLEOTOMY
  - Principle
  - Technique
- PRECHOP
  - Principle
  - Technique
    - Karate Prechop
    - Counter Prechop
- REMOVAL OF LAST TWO NUCLEAR PIECES
- REMOVAL OF RETAINED LENS FRAGMENTS
- EPINUCLEUS REMOVAL
CHAPTER 18:Slow-Motion Phacoemulsification Technique
- HISTORY
- CURRENT TECHNIQUE
  - Pre-phacoemulsification
- PHACOEMULSIFICATION TECHNIQUE
- POST-PHACOEMULSIFICATION
- NUCLEAR TYPES
- MANAGEMENT OF COMPLICATIONS
CHAPTER 19:Microincision Cataract Surgery
- INTRODUCTION
- MICS SURGICAL INSTRUMENTS
- SURGERY OF MICS WITH LOW ULTRASOUND1–4
- SURGERY OF MICS WITH DODICK PHOTOLYSIS ND:YAG TECHNOLOGY
  - Future Developments in MICS Surgery
CHAPTER 20:Application of New Technology in Adult and Pediatric Cataract Surgery
- INTRODUCTION
- BIOMETRY AND IOL CALCULATION
- INCISION CONSTRUCTION
- VISCOELASTIC DEVICES
- ANTERIOR CAPSULOTOMY
- ENDOCAPSULAR RINGS
- STAINING OF THE LENS CAPSULE
- MANAGEMENT OF SMALL PUPILS
- NEW PHACOEMULSIFICATION TECHNOLOGY
- PHACOBURST
- WHITESTAR
- SONIC PHACOEMULSIFICATION
- NEOSONIX PHACOEMULSIFICATION
- LASER PHACOEMULSIFICATION
- AVANTIX
- AQUALASE
- BIMANUAL ULTRASOUND PHACOEMULSIFICATION
- ENDOSCOPIC CYCLOPHOTOCOAGULATION
- INTRAOCULAR LENS MATERIAL AND DESIGN
- CONCLUSION
CHAPTER 21:Irrigation and Aspiration
- INTRODUCTION
- DIFFERENCES IN CORTICAL ASPIRATION DURING EXTRACAPSULAR CATARACT EXTRACTION AND PHACOEMULSIFICATION SURGERY
- THE CO-AXIAL AUTOMATED IRRIGATION/ASPIRATION HANDPIECE
  - Surgical Technique
- SUBINCISIONAL CORTEX
- BIMANUAL IRRIGATION-ASPIRATION
- INDICATIONS
- INSTRUMENTATION
- SURGICAL TECHNIQUE
- RECALCITRANT EPINUCLEAR PLATE/CORTICAL MATTER
- POSTERIOR CAPSULE VACUUMING AND POLISHING
- INSTRUMENTATION
- ANTERIOR CAPSULE VACUUMING AND POLISHING
- CORTICAL CLEAN-UP IN COMPLICATED SITUATIONS
  - Posterior Capsular Tear
  - Zonular Dialysis/Subluxated Cataract
CHAPTER 22:Phaco Profile Intraocular Lenses: Designs, Materials and Types
- PHACO PROFILE IOLs
- RIGID POLYMETHYL-METHACRYLATE (PMMA)
- FOLDABLE IOLs
  - Haptic Materials
  - Designs of IOL (Based on Haptic)
    - Three-piece or Single-piece Foldable Looped IOLs
    - Solid Plate Haptic Foldable IOLs
- ROLLABLE FOLDABLE IOLs
- FOLDABLE IOLs
  - Acrylate/ Methacrylate Polymers
    - Flexible—Hydrophobic Acrylate
- THREE PIECE ACRYLIC LENSES
- SILICONE ELASTOMERES
  - Plate Haptic Lenses
  - Three Piece Looped Lenses
    - SI40NB
    - CeeOn edge 911A
- COLLAMER
- SPECIALIZED LENSES
- PSEUDOACCOMMODATING/ACCOMMODATING IOLs
  - Multifocal Intraocular Lenses
    - Refractive Multifocal IOLs
    - Diffractive Multifocal IOLs
  - 1CU Acrylic Accommodative IOL
- TORIC LENS DESIGNS
  - Laser Adjustable IOL
  - Acri.Smart 48S™ IOL
- TECNIS Z9000 IOL
  - Implantable Miniatured Telescopes
CHAPTER 23:Technique of Intraocular Lens Implantation
- TECHNIQUE OF IMPLANTATION
- PMMA IOL INSERTION TECHNIQUES
- FOLDABLE IOL INSERTION TECHNIQUES
  - Forceps Delivery Systems
    - Horizontal or Longitudinal Direction
    - Vertical or Transverse Direction
  - Injector Delivery System
CHAPTER 24:Intraocular Lens Explantation and Exchange
CHAPTER 25:Complications Related to Foldable Intraocular Lens
- DESCEMET'S MEMBRANE DETACHMENT
- POSTERIOR CAPSULAR RUPTURE
- DAMAGE TO THE IOL
- BAG SULCUS SYNDROME
- CAPSULAR DISTENTION SYNDROME
  - Prevention
  - Treatment
- POSTOPERATIVE UVEITIS
- GLISTENINGS
- GLARE
- MARKS ON THE IOL
- DISCOLORATION AND CALCIFICATION OF THE INTRAOCULAR LENSES
- SILICONE OIL ADHERENCE TO IOL
- DECENTRATION OF IOL
- ENDOPHTHALMITIS
- POSTERIOR CAPSULAR OPACIFICATION (PCO)
CHAPTER 26:Phacoemulsification for Residents
- CASE SELECTION
- PUPILLARY DILATATION
- ANESTHESIA
- SURGICAL SITE
- INCISION
- CAPSULORHEXIS
- HYDROPROCEDURES
- PHACOEMULSIFICATION
- CORTICAL ASPIRATION
- IOL IMPLANTATION
- WOUND CLOSURE
- WET LAB TRAINING
- CONCLUSION
CHAPTER 27:Conversion of Phacoemulsification to Extracapsular Cataract Extraction
SECTION 4: COMPLICATIONS: PREVENTION AND MANAGEMENT
CHAPTER 28:Wound Related Problems
- WOUND SIZE
  - Small Wound
    - Management
  - Large Wound
    - Management
- PREMATURE ENTRY
  - Management
- WOUND BURN
- WOUND INFECTION
  - Bacterial Keratitis
  - Fungal Keratitis
    - Management
CHAPTER 29:Iris Complications in Phacoemulsification
- IRIS PROLAPSE
  - Causes
  - Management
- IRIS CHAFING
- IRIDODIALYSIS
  - Causes
  - Management
CHAPTER 30:Postoperative Complications of Capsulorhexis
- CAPSULAR CONTRACTION SYNDROME
CHAPTER 31:Posterior Capsular Tear: Avoidance, Recognition and Management
- INTRODUCTION
- COMMON PREDISPOSING FACTORS TO COMPLICATIONS3,4
- INTRAOPERATIVE COMPLICATIONS
- CONCLUSION
CHAPTER 32:Posterior Capsule Opacification
- REASONS TO ERADICATE POSTERIOR CAPSULE OPACIFICATION
- ETIOPATHOGENESIS
- LENS EPITHELIAL CELLS PROLIFERATION: ROLE OF GROWTH FACTORS
- CLINICAL MANIFESTATIONS AND TREATMENT
- SURGICAL AND IMPLANT RELATED FACTORS FOR PREVENTION OF POSTERIOR CAPSULE OPACIFICATION
  - Surgery-Related Factors to Reduce PCO
  - Implant-Related Factors to Reduce PCO
- CONFIRMATION OF SURGICAL AND IMPLANT RELATED FACTORS IN THE LABORATORY AND CLINICAL STUDIES
  - Laboratory Analysis of Nd: YAG Posterior Capsulotomy Rates in Pseudophakic Human Eyes Obtained Postmortem
  - Confirmation of the Six Factors in Clinical Studies
- PHARMACOLOGICAL PREVENTION OF POSTERIOR CAPSULE OPACIFICATION
- SEALED CAPSULE IRRIGATION FOR MAINTAINING POSTOPERATIVE CAPSULAR BAG TRANSPARENCY
- REMOVAL OF LENS EPITHELIAL CELLS USING AQUALASE® LIQUEFACTION DEVICE
- SUMMARY AND CONCLUSIONS
CHAPTER 33:Post Phacoemulsification Endophthalmitis
- RISK FACTORS
- CLINICAL FEATURES
  - Symptoms
  - Signs
- MANAGEMENT
- PREVENTION
SECTION 5: SPECIAL SITUATIONS
CHAPTER 34:Phacoemulsification in Eyes with Previous Keratorefractive Surgery
- WOUND CONSTRUCTION
- INTRAOPERATIVE VISUALIZATION AND CORNEAL PROTECTION
- CALCULATION OF IOL POWER
- DIRECT CHANGE OF CENTRAL ANTERIOR CORNEAL CURVATURE
- INDIRECT CHANGE OF CENTRAL ANTERIOR AND POSTERIOR CORNEAL CURVATURE
  - How to Calculate Accurate IOL Power?
- KERATOMETRY
- AVERAGE CENTRAL POWER (ACP)
- SLIT SCANNING PANCORNEAL TOPOGRAPHY
- CALCULATING K
- POSTOPERATIVE RESULTS AFTER RK
- LONG-TERM RESULTS AFTER RK
- RESULTS AFTER PRK/ LASIK
- PRACTICAL TIPS
CHAPTER 35:Phacoemulsification in High Myopia, High Hyperopia and Astigmatism
- PHACOEMULSIFICATION IN HIGH MYOPIA
- PHACOEMULSIFICATION IN HYPEROPIA
- PHACOEMULSIFICATION IN HIGH ASTIGMATISM
CHAPTER 36:Phacoemulsification in Rock Hard Cataracts
- RISK FACTORS AND CAUSES OF HARD CATARACTS
  - Clinical Features
- SURGICAL TECHNIQUE
  - Steps of Technique
CHAPTER 37:Phacoemulsification in Intumescent Cataract
- INTRODUCTION
- INTRAOPERATIVE PROBLEMS
- PREOPERATIVE CONSIDERATIONS
- INCISION
- CONTINUOUS CURVILINEAR CAPSULORHEXIS
- HYDROMANEUVERS
- NUCLEAR EMULSIFICATION
- IRRIGATION-ASPIRATION
- IOL IMPLANTATION
CHAPTER 38:Phacoemulsification in Eyes with Corneal Opacification
- INTRODUCTION
- ASSESSMENT OF CORNEA AND CATARACT
- INVESTIGATIONS
- SURGICAL TECHNIQUES
CHAPTER 39:Small Pupil Clear Corneal Phacoemulsification Surgery
- INTRODUCTION
- PHARMACOLOGICAL AGENTS
- VISCOMYDRIASIS
- MECHANICAL DEVICES
- MECHANICAL STRETCHING METHOD
- CUTTING METHOD
- IRIS RETAINER METHOD
  - Acknowledgement
CHAPTER 40:Phacoemulsification in Pseudoexfoliation Syndrome
- INTRODUCTION
- DIAGNOSTIC CLUES
- PREOPERATIVE MEASURES
- INTRAOPERATIVE CONSIDERATIONS
- POSTOPERATIVE COMPLICATIONS
CHAPTER 41:Phacoemulsification in Posterior Polar Cataracts
- SURGICAL TECHNIQUE
- INSIDE-OUT DELINEATION
  - Modifications
- SUMMARY
CHAPTER 42:Phacoemulsification in Subluxated Lenses
- PREOPERATIVE PREPARATION
CHAPTER 43:Phacoemulsification in Eyes with Chronic Uveitis
- SURGICAL TECHNIQUE
CHAPTER 44:Surgical Management of Coexisting Glaucoma and Cataract
- PREOPERATIVE EVALUATION
- OPTIONS FOR SURGICAL MANAGEMENT
- SURGICAL TECHNIQUE
- POSTOPERATIVE MANAGEMENT
- MANAGEMENT OF POSTOPERATIVE COMPLICATIONS
- CONCLUSION
CHAPTER 45:Phacoemulsification in Traumatic Cataracts
- INTRODUCTION
- PREOPERATIVE EVALUATION
- OPERATIVE PLANNING AND TECHNIQUE
  - Anesthesia
  - Incision
- ANTERIOR CAPSULOTOMY
- PHACOEMULSIFICATION AND IOL IMPLANTATION
- IOL IMPLANTATION IN TRAUMATIC CATARACTS
- MANAGEMENT OF IRIS INJURY
- OUTCOMES
CHAPTER 46:Phacoemulsification in Colobomatous Eyes
CHAPTER 47:Phacoemulsification in Eyes following Vitreoretinal Surgery
- INTRODUCTION
- PREOPERATIVE CONSIDERATIONS
- INTRAOPERATIVE CONSIDERATIONS
- COMBINED PHACOEMULSIFICATION AND SILICONE OIL REMOVAL
  - Surgical Procedure
    - Silicone Oil Removal Through Posterior CCC
    - Silicone Oil Removal Through Pars Plana Route

INDEX

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Index

Chapter Notes