Index

Techniques of Cataract Surgery Amar Agarwal, Mahipal S Sachdev, Harinder S Sethi, Ritu Gadia

SECTION ONE: MANUAL SMALL INCISION CATARACT SURGERY
1:SICS-Fishhook Technique
- INTRODUCTION
- TRANSITION FROM SUTURED TO SUTURELESS CATARACT SURGERY
- SUMMARY
2:Basic Techniques of SICS
- SURGICAL TECHNIQUE
- ANTERIOR CAPSULOTOMY
- TECHNIQUES FOR NUCLEUS DELIVERY
- CORTICAL ASPIRATION
  - Epinucleus Removal
    - Hydroexpression
    - Viscoexpression
- MANUAL ASPIRATION
- AUTOMATED ASPIRATION
- PREVENTION AND MANAGEMENT OF COMPLICATIONS
SECTION TWO: PHACOEMULSIFICATION
3:Anesthesia
- INTRODUCTION
- ANESTHESIA FOR PHACO
- LOCAL ANESTHESIA
  - Peribulbar (Periocular) Technique
  - Parabulbar (Flush) or Sub-Tenon Akinesia
    - Technique
    - Complications
- TOPICAL ANESTHESIA
  - Intracameral Anesthesia
- NO ANESTHESIA CATARACT SURGERY
4:The Phaco Machine and Phacodynamics
- INTRODUCTION
- BASIC FUNCTIONS
- NEW POWER MODES
  - Variable Phaco Rise Time (Fig. 4.6A)
  - Occlusion Mode
- IRRIGATION SYSTEM
  - Aspiration System
  - Aspiration Pumps
- FOOT PEDAL (FIG. 4.9)
- HOW TO TACKLE SURGE?
  - Principles
- SONIC PHACOEMULSIFICATION
- NEOSONIX PHACOEMULSIFICATION
- WHITESTAR TECHNOLOGY
  - Catarex
  - Aqualase
- ER: YAG LASER PHACOEMULSIFICATION
5:Phaco Tips
- INTRODUCTION
- NEW MODIFICATIONS OF THE PHACO TIPS
6:Biometry and IOL Power Calculation
- INTRODUCTION
- THE TARGET POSTOPERATIVE REFRACTION
- CALCULATION OF THE IOL POWER
7:Instrumentation for Phacoemulsification
- MATERIAL FOR PHACO-INSTRUMENTS
- INCISION AND WOUND CONSTRUCTION
- INSTRUMENTS USED FOR CHOPPING AND MANIPULATIONS OF NUCLEUS
- INSTRUMENTS FOR SPECIAL SITUATIONS
  - Management of Small Pupil
- MANAGEMENT OF WEAK ZONULES
8:Ophthalmic Viscosurgical Devices
- CLASSIFICATION OF THE OVDs
- SURGICAL APPLICATION OF THE OVDs
- COMPLICATIONS OF OVDs
- SUMMARY AND CONCLUSIONS
9:Irrigating Solutions and Additives
- ENHANCED SOLUTIONS
- MYDRIATICS
- MIOTICS
- ANTIBIOTICS
  - Anti-inflammatory Drugs
- ANESTHESIA
- PRESERVATIVES
10:Anterior Capsule Staining
11:The Phaco Incision: Surgical Aspects and Astigmatic Considerations
- THE VALVULAR INCISION
- INSTRUMENTS REQUIRED FOR THE PHACO INCISIONS
- TECHNIQUE OF MAKING A PHACO INCISION
- SUMMING UP
- ASTIGMATIC CONSIDERATIONS
- ACHIEVING EMMETROPIA
- ASTIGMATICALLY NEUTRAL FUNNEL
- PHACOEMULSIFICATION IN EYES WITH HIGH PREOPERATIVE ASTIGMATISM
12:Continuous Curvilinear Capsulorhexis
- ANATOMY OF THE LENS CAPSULE
  - Technique
- TWO-STAGED CAPSULORHEXIS
- POSTERIOR CAPSULORHEXIS
- ANTERIOR VITRECTORHEXIS
- RADIOFREQUENCY DIATHERMY
- PLASMA BLADE
- INTUMESCENT CATARACTS AND CAPSULORHEXIS
- TEARING BY STRETCHING
- TEARING BY SHEARING
  - Size of Capsulorhexis
- DIFFICULTIES DURING RHEXIS
  - Rhexis Escape
- TECHNIQUES OF RECOVERING AN ESCAPING RHEXIS
  - Complications of Capsulorhexis
  - Capsular Contraction Syndrome
- CAPSULAR BAG DISTENSION
- PITFALLS and REMEDIES
13:Hydroprocedures
- HYDRODISSECTION
14:Single Instrument Phacoemulsification
- INTRODUCTION
- SINGLE INCISION PHACOEMULSIFICATION: THE FOUR-STEP KEYHOLE TECHNIQUE
- CONCLUSION
15:Supracapsular Phacoemulsification
- INTRODUCTION
- HISTORY OF SUPRACAPSULAR PHACOEMULSIFICATION
- WHAT IS SUPRACAPSULAR PHACOEMULSIFICATION?
- SURGICAL TECHNIQUE
- PHACO-HEMI FLIP
- PHACO FLIP
- TILT AND TUMBLE PHACO
- SUPRACAPSULAR QUICK CHOP PHACO
- OTHER VARIATIONS
  - Bruce Wallace
  - Irrigation, Aspiration and IOL Insertion
- ADVANTAGES
- SUPRACAPSULAR PHACOEMULSIFICATION IN DIFFICULT CASES
- NEW GENERATION PHACO MACHINES AND SUPRACAPSULAR PHACOEMULSIFICATION
16:Advanced Nucleotomy Techniques
- INTRODUCTION
- THE BASIC TECHNIQUE
  - Phacoemulsification by Divide and Conquer
    - Crater Divide and Conquer
    - Trench Divide and Conquer with Down Slope Sculpting
  - Stop and Chop
- CHOPPING TECHNIQUES
  - Nagahara Chop/Horizontal Chop
  - Karate Chop/Vertical Chopping
- PERSONAL NUCLEOTOMY TECHNIQUES
  - Modified Phacoemulsification In Situ
  - Technique
- PETALLOID NUCLEOTOMY
  - Technique
- SINUS FRACTURE NUCLEOTOMY
  - Technique
- INTRANUCLEAR NUCLEOTOMY
  - Technique
- CRATER AND CHOP
- INTERCAPSULAR PHACOEMULSIFICATION
  - Technique
- PHACO SLICE AND SEPARATE
- PHACO PRECHOP NUCLEOTOMY
17:Cortical Aspiration
- ADVANTAGES OF COMPLETE CORTICAL ASPIRATION
  - Automated Irrigation Aspiration Systems
  - Manual Irrigation Aspiration System
- GUIDELINES FOR ADEQUATE CORTICAL ASPIRATION
- MANAGEMENT OF ANTERIOR CAPSULAR TAGS
- ASPIRATION OF SUBINCISIONAL CORTEX
- REMOVAL OF VISCOELASTIC AFTER INTRAOCULAR LENS IMPLANTATION
- REMOVAL OF HEALON 5
- VISCOELASTIC REMOVAL AFTER RIGID PMMA IOL IMPLANTATION
18:Intraocular Lenses
- INTRODUCTION
- CLASSIFICATION OF IOLs
- OPTIC MATERIALS FOR IOLS (Table 18.2)
- PROFILE OF RIGID IOLs USED FOR PHACOEMULSIFICATION
- FOLDABLE IOLs
- MONARCH II DELIVERY SYSTEM
- THE UNFOLDER IMPLANTATION SYSTEM
- MULTIFOCAL AND ACCOMMODATING INTRAOCULAR LENSES
- PIGGYBACK INTRAOCULAR LENSES
- NEW IOLs FOR MICROINCISION CATARACT SURGERY
- WAVEFRONT BASED INTRAOCULAR LENSES
- IMPLANTABLE MINIATURIZED TELESCOPE (IMT)
- THE PRISMATIC IOL
- BLUE LIGHT-FILTERING IOL
- ANIRIDIA IOL
- COMPLICATIONS OF FOLDABLE INTRAOCULAR LENSES
- ENDOPHTHALMITIS
SECTION THREE: PHAKONIT
19:Bimanual Phaco: Basic Concepts
- INTRODUCTION
- SPECIAL ISSUES
  - Methods to Prevent Thermal Burns
  - Surge Control in Bimanual Phaco
- CONCLUSION
20:Phakonit
- HISTORY
- PRINCIPLE
- TERMINOLOGY
- SYNONYMS
- TECHNIQUE OF PHAKONIT FOR CATARACTS
- ANTI-CHAMBER COLLAPSER
- THINOPTX ROLLABLE IOL
- LENS INSERTION TECHNIQUE
- ROLLER
- TOPOGRAPHY
- LASER PHAKONIT
- THREE-PORT PHAKONIT
  - Cruise Control
  - Duet System
- SUMMARY
21:Microphaconit: Cataract Surgery with A 0.7 mm Tip
- INTRODUCTION
- MICROPHAKONIT (0.7 MM) NEEDLE TIP
- MICROPHAKONIT (0.7 MM) IRRIGATING CHOPPER
- AIR PUMP AND GAS FORCED INFUSION
- BIMANUAL 0.7 MM IRRIGATION ASPIRATION SYSTEM
- DUET HANDLES
- DIFFERENCES BETWEEN 0.9 MM AND 0.7 MM SETS IN CATARACT SURGERY
- TECHNIQUE
- SUMMARY
SECTION FOUR: NEW TECHNIQUES
22:Cataract Surgery with Dodick Laser Photolysis
- INTRODUCTION
- TECHNICAL FUNDAMENTALS OF LASER PHOTOLYSIS SYSTEM
- SELECTION OF PATIENTS AND INDICATIONS
- SURGICAL TECHNIQUE WITH DODICK LASER PHACOLYSIS: OUR EXPERIENCE
  - Transition from Phacoemulsification
  - Converting into Phacoemulsification
- CATARACT SURGERY AND CLEAR LENS EXTRACTION IN HIGH MYOPIA WITH PHOTOLYSIS LASER SYSTEM: OUR TECHNIQUE
- POSTOPERATIVE MEDICATION
- COMPLICATIONS
  - Endothelial Cell Count
  - Posterior Capsule Rupture
- ADVANTAGES AND DISADVANTAGES
- FUTURE TRENDS
- SUMMARY
23:New Non-laser Phacoemulsification Technologies
- INTRODUCTION
  - Sonic Phacoemulsification
- NEOSONIX PHACOEMULSIFICATION
- WHITE STAR TECHNOLOGY
- AVANTIX
- AQUALASE
- CONCLUSION
SECTION FIVE: SPECIAL SITUATIONS
24:Phacoemulsification in Eyes with Uveitis
- INTRODUCTION
- PROBLEMS OF CATARACT SURGERY IN UVEITIS PATIENTS
  - Intraoperative Complications
  - Postoperative Complications
- WHEN TO UNDERTAKE SURGERY
- PREOPERATIVE EVALUATION
  - Preoperative Control of Inflammation
- INTRAOPERATIVE MEASURES
- CHOICE OF INTRAOCULAR LENS
- POSTOPERATIVE MEASURES
- OUTCOME OF PHACOEMULSIFICATION IN UVEITIS
25:Refractive Cataract Surgery
- INTRODUCTION
- IOL POWER ACCURACY
- POSTOPERATIVE MEASURES
- POSTOPERATIVE AUDIT
26:Small Pupil Phacoemulsification
- INTRODUCTION
- PREOPERATIVE EVALUATION
- PHARMACOLOGICAL MYDRIASIS
- INTRAOPERATIVE PROCEDURES
  - Intraoperative Procedures not Involving the Sphincter
  - Intraoperative Procedures Involving the Sphincter
    - Mini Sphincterotomies
    - Pupil Stretch
- INSTRUMENTATIONS
- IRIS RETAINER METHODS
  - Pupil Ring Expanders
  - Perfect Pupil Device™
- SURGICAL COMPLICATIONS
- PHACOEMULSIFICATION PEARLS
27:Phacoemulsification Following Vitreoretinal Surgery
- INTRODUCTION
- WHAT ARE THE PROBLEMS?
- PREOPERATIVE EVALUATION
- INTRAOPERATIVE MEASURES
- POSTOPERATIVE EVALUATION
- COMBINED PHACOEMULSIFICATION AND SILICONE OIL REMOVAL
  - Procedure
    - Through Anterior Transpupillary Route17–21
    - Through Pars-plana Route
- OUTCOMES OF PHACOEMULSIFICATION FOLLOWING VITREORETINAL SURGERY
28:Phacoemulsification in High Myopia
- INTRODUCTION
- PREOPERATIVE CONSIDERATIONS
- INTRAOPERATIVE CONSIDERATIONS
- POSTOPERATIVE CONSIDERATIONS
- CONCLUSIONS
29:Phacoemulsification in Eyes with Poor Endothelial Function
- INTRODUCTION
- ROLE OF ANESTHETIC AGENTS
- ROLE OF VARIOUS CHEMICAL AGENTS
- ROLE OF IRRIGATING FLUID
- ROLE OF SURGICAL INCISION
- ROLE OF VISCOELASTIC AGENTS
- ROLE OF VARIOUS TECHNIQUES EMPLOYED
- ROLE OF INTRACAMERAL INJECTIONS
- ROLE OF POSTOPERATIVE MEDICATION
- PHACOEMULSIFICATION IN POST-KERATOPLASTY EYES
- TO SUMMARISE
30:Phaco in Subluxated Cataracts
- INTRODUCTION
- CAPSULAR TENSION RING INSERTION
- TECHNIQUE
- SPECIAL CONDITIONS
- DROPPED ENDOCAPSULAR RING
- SUMMARY
SECTION SIX: PREVANTION AND MANAGEMENT OF COMPLICATIONS
31:The Prevention of Complications and Their Management in Phacoemulsification
- PREVENTIVE ASPECTS PRIOR TO COMMENCING PHACOEMULSIFICATION
- COMPLICATIONS AT VARIOUS PHASES OF PHACOEMULSIFICATION SURGERY
32:Managing Dislocated Lens Fragments
- INTRODUCTION
- THE RESPONSIBILITY OF THE CATARACT SURGEON
- TECHNIQUES FOR REMOVING POSTERIORLY DISLOCATED LENS FRAGMENTS
- CONCLUSION
33:Prevention and Treatment of Infection after Cataract Surgery
- PREVENTION OF POSTOPERATIVE ENDOPHTHALMITIS
- TREATMENT OF POST-CATARACT SURGERY ENDOPHTHALMITIS
34:Post Cataract Surgery Cystoid Macular Edema
- INTRODUCTION
- DEFINITION
- PATHOGENESIS
  - Risk Factors
- CLINICAL FEATURES
- DIFFERENTIAL DIAGNOSIS
- NATURAL COURSE
- PROPHYLAXIS
- MANAGEMENT
- CONCLUSIONS
SECTION SEVEN: PEDIATRIC CATARACT SURGERY
35:Pediatric Cataract Surgery and Intraocular Lens Implantation
- INTRODUCTION
- DIAGNOSIS OF PEDIATRIC CATARACTS
- CATARACT SURGERY IN CHILDREN
- SURGICAL TECHNIQUES
- DYE-ENHANCED PEDIATRIC CATARACT SURGERY
- PEDIATRIC TRAUMATIC CATARACTS AND THEIR MANAGEMENT
- PERIOPERATIVE AND POSTOPERATIVE TREATMENT
- POSTOPERATIVE COMPLICATIONS AND MANAGEMENT
  - Early Onset
  - Intermediate/Late Onset
- RESIDUAL REFRACTIVE ERROR
  - Piggyback Foldable Intraocular Lenses in Infants
- MANAGEMENT OF AMBLYOPIA
- SUMMARY AND CONCLUSIONS

INDEX

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Index

Chapter Notes