The Science & Art: Microincision Cataract Surgery (BIMICS & COMICS) Arturo Pérez-Arteaga, Luis Felipe Vejarano-Restrepo
INDEX
ABCDEFGHIJKLMNOPQRSTUVWZ
Page numbers followed by f refer to figure and t refer to table
A
19 gauge Vejarano's irrigating chopper 84f
20 gauge
ophthalmic knife 126f
Vejarano's irrigating chopper 84f
25 gauge transcleral pars plana vitrectomy 167f
26 gauge Gimbel cannula 80f
27 gauge cannula 120f
700 micron irrigating and aspirating cannulas inside eye 218f
Abbott medical optics 53
Acoustic wave 20
Acrysmart lens 137f
Adhesion of pupillary membrane 166f
Advantages of C-MICS (1.6 mm) surgery 19
Age-related cataract 147
Air pump 116t
and gas forced infusion 115
of millennium surgical system 8f
Akahoshi combo prechopper 94f, 112f
Alcon
accurus 600 56
infinity system 103
Alio
MICS
aspiration handpiece 56f
capsulorhexis forceps 54f
diamond knife 54f
irrigating stinger 55f
metal knife 54f
original finger nail MICS irrigating hydromanipulator 55f
AMO
chamber automated stabilization environment 91
dual-pump technology 92
phacoemulsification technology 95f
whiteStar settings 88f
Anesthesia 93, 110, 125
Anterior
cataract 147
chamber
depth 183
formed with viscoelastic 220f
continuous curvilinear capsulorhexis 174
cortical cataract 147
polar cataract 147
subcapsular cataract 147
uveitis 183
vented gas forced infusion 4, 12, 205
system 115
tubing system of accurus surgical system 13
Artist rendering of ice pulse 90f
Aspiration 127
bypass system 104
cannulas 213f
process
in progress 213f
starting 213f
tips 208f
Astigmatism control with MICS 61
B
Balanced salt solution 4, 7, 103, 126, 133, 152, 204
Best choice in pediatric cataracts 204
Biaxial
cataract 198
surgery 5
microincision
cataract surgery 13, 19, 45, 47, 124
instruments 168
phacoemulsification 159
phaco surgical tools 75
phacoaspiration 5
prechop technique 194
refractive lens exchange 5
technique 148
Bimanual
0.7 mm irrigation aspiration system 116
irrigation 127, 127f, 208f
microincision phacoemulsification of cataract 168f
microincisional surgery 6
phacoemulsification 6, 34f, 126f
Biometry with IOL master 125
Bipolar
capsulotomy 41
diathermy 41
glaucoma surgery 41
intraocular microcauterization 168f
Bottle
infusion 14
tool of millennium microsurgical system 13
of intraocular solution 12
Burst modulation 42
C
Cannulas
inside eye 141f
performing nucleus fragmentation 218f
Capsular
bag 195
tension rings 156, 207
Capsulorhexis 28, 28f, 78, 125, 126f, 149, 174, 199
Cataract
incisions 32, 32f
removal and intraocular lens 32
surgery 27, 116
Chamber automated stabilization environment 91
Change in axis of cannulas 142f
Charlie Kelman patented phacoemulsification 32f
Chopping
rock hard nucleus 162f
technique 121f
Classification of lens hardness according to Moh's scale 27t
Clear
corneal incisions 32, 199f
lens exchange 41
CMP cool phaco 41
Coaxial
cataract surgery 5
microincision
cataract surgery 13, 34, 32, 17, 19, 35
phacoemulsification of cataracts 19
phaco techniques 34
phacoaspiration 5
Comparison of
dimensions 25f
energy modes 88f
phaco
needles from microflow 208f
system 102f
tip diameters 82f
Complete clean of capsular bag 219f
Congenital cataracts 215
Continuous
curvilinear capsulorhexis 54, 206
irrigation 41
linear 42
transition of cataract surgery 52
Cool
micropulse button 38
micropulse phaco 42
Corneal
aberration with MICS 62
edema 183
endothelial cell count 125
endothelium 9
wound burn 87f
Cortex
completely removed 168f
irrigation-aspiration 30t
removal 109
Creating forced infusion 12
Cruise Control™ System 53f
Custom pulse for grade
2 cataract 108f
3 cataracts 108f
D
Deformation resistance 32
Detached descemet membrane 173
Developmental cataracts 215
Dexamethasone phosphate 128
Diagram of multiple fracture 28
Diamond
blade for side port incision 148f
keratome 122f
Dilemma of sleeveless biaxial microphaco 38f
Dispersive viscoelastic protection 24
Dominant hand 700 micron incision 212f
E
Elschnig's pearls 211, 211f
End of phaco notice clear bag and clean cornea 144f
Epinucleus 109
mode 110f
Evolution of surgical techniques 3
Excessive anterior chamber deepening 173
Execution of sclerocorneal tunnel 127f
External
air pump with air filter connected 8f
forced infusion 5, 11, 15
roller clamp in millennium surgical system 12f
F
Final steps 201
Finishing
aspirating process 213f
microcapsulorhexis 217f
First
fracture 28
scleral stopper in place 200f
step in collocation of scleral stoppers 199f
Fluidics and regulation of emulsification energy 20
Foot pedal control 105
Forced infusion 5, 7, 11
Frontal opening irrigating chopper 82f
Fuchs' dystrophy 183
G
Gas forced infusion 53, 116t
Gauge
cannulas 140f
microvitreoretinal blade 119f
of phaco needles and size of incision 75t
Gentle
hydrodissection 120, 189
hydrosurgery 189
nuclear rotation 189f
Goldmann applanation tonometry 125
H
Hard
cataract with reabsorbed cortex 151
lenses 29
High
molecular weight 135
myopia 159
speed vitrectomy 41
Higher order astigmatism 62
Hydrodelamination 140f, 217f
Hydrodelineation of posterior polar cataract 159f
Hydrodissection 29, 29f, 79, 116t, 140f, 152, 200
Hydrowave 20
Hypermature
cataract 147
senile cataract 147
I
Immature senile cataract 147
Implantation of intraocular lens 124
Incision 28, 28f, 52, 75, 93, 111, 148, 199
extracapsular cataract extraction 180
sites 126f
Incisional
burns 171
edema 213f
Incomplete capsulorhexis 188
Inferior opening irrigating chopper 82f
Initial hydrodissection wave 217f
Injection of
capsule tension ring 162f
viscosurgical device 125
Intelligent phaco 104
Internal
forced infusion 5, 11, 15
gas forced infusion 115
Intraocular
cautery 167
floppy iris syndrome 156
lens 4, 9, 49, 52, 84, 145f, 151, 159, 173, 198, 204, 212
choice 95
implantation 201
injection with injector 128f
insertion 127
pressure 11, 53, 195f, 198
Intraoperative
floppy iris syndrome 47, 116t, 163, 164f
trauma 183
Introduction of 700 micron irrigation 213f
Intumescent cataracts 149, 215
IOL implantation 31f
Iris
bombé 165
coloboma 163f
prolapse 116t
Irrigating
cannula placed behind nucleus 192f
chopper 83t, 116t
20 gauge 76f
Irrigation
administration set 12
aspiration 136f
choppers 81
Irrigator tamponading iris 164f
J
Jackhammer effect 24
K
Kershner's microrhexis forceps 134
L
Large iridodialysis and zonular defects 163
Lateral opening irrigating chopper 83f
Lens
hardness 27
iris diaphragm retropulsion syndrome 173
multiple phacofracture 29
opacities classification system 27
salute
microphaco 133, 136f
position 135f, 189
technique 190
M
Maintaining positive intraocular pressure with irrigation 192
Malignant melanoma 163f
Management of incomplete capsulorhexis cases with biaxial approach 188
Mapping of footswitch 106
Mature
cataract 147, 160
senile cataract 147
Maximum phacoemulsification power 127
Mehta microrhexis forceps 134f
Metal blade 85f
Micro capsulorhexis forceps 19f
Micro-biaxial
cataract surgery 5, 197
cortical aspiration 219f
epinuclear aspiration 219f
nuclear pieces aspiration 219f
phacoaspiration 5
posterior capsule cleaning 211
prechop technique 139
refractive lens exchange 5
Micro-coaxial
cataract surgery 5
phacoaspiration 5
phacoemulsification 153t
Microcornea 163
Microincision 5
cataract surgery 4, 6, 14, 33, 42, 52, 124, 125, 204
instruments 54
phacoemulsification platforms 56
intraocular lenses 58t
Microphaco 6
Microphakonit 6, 116, 114, 117
22 gauge Vejarano's irrigating chopper 208f
irrigating chopper 114
needle tip 114
Microphthalmos 163
Microslim IOL 60f
Microtip 20 gauge 81f
Microutrata forceps 79f
MICS
capsulorhexis forceps 126f
intraocular lenses 57
with infinity surgical system 102
Middle micro-capsulorhexis 217f
Milky cataracts 215
Millenium surgical system 14
Mini flared tip 25
Miniflex IOL 61f
Minimally invasive cataract surgery 52
Modified phaco needle 19f
Morcher pupil expander ring 165f
Morgagnian cataract 147
Multi-mode phaco 41
Multiple nuclear
fragmentation 143f
pieces 143f
MVR blade 20 gauge 149f
N
Nanotip 22 gauge 81f
Natural clear cornea vejarano‘s microincision knife 76f
Needle
allows coaxial microphaco 35
puncture of anterior capsule 150f
Nondominant hand 700 micron incision 212f
Normal saline solution 183
Nuclear
cataract 147
fragmentation 191f, 193f, 194f, 218f
Nucleus
and endothelial cells 141f
and posterior capsule 141f
embed with phaco needle 191f
fragmented 218f
held firmly with vacuum 192f
in lens salute position 140f
pulled with vacuum 192f
starting fragmentation with vacuum and irrigating cannula 193f
O
Occlusion mode phaco 41, 42
Ocular pressure 125
Oertli
phaco technology 35f
Swiss technology 32
Olson irrigating chopper 133
Ophthalmic
viscoelastic device 148
viscosurgical device 110, 112
Optical coherence tomography 167f
P
Pars plana vitrectomy 7, 197, 201, 201f, 202f
Passive infusion 5, 10, 11
Penetrating keratoplasty 157
Performance of scleral tunnel incisions 199f
Peripheral iridotomy 166f
Phaco
handpiece 4
instrumentation 35
multiple nuclear pieces 145f
needles 20, 80, 116t
tip
and irrigating cannula 145f
selection 104
vitreoretinal platform 37f
Phacoemulsification 126, 152, 200
energy 167f
of nuclear pieces 194f
of segments 30
of subluxed cataract in anterior chamber 160f
Phakonit 3, 6, 116
and microphakonit 116t
Pinching infusion tubing 168f
Poiseuille's law 153t
Polish
mode with linear control of vacuum and flow 110f
of posterior capsule 219f
Polishing capsule 110
Polymethylmethacrylate 52
Posterior
capsule 9
opacity 211
polishing 127f
rents 178
rupture 161
cataract 147
cortical cataract 147
polar cataract 147, 159, 215
subcapsular cataract 147
subluxed cataracts 160
vitrectomy 202f
Potential intraoperative floppy iris syndrome 165
Power modulation 53
Prechop with irrigating cannula and phaco tip 193f
Prechopping in micro-coaxial phaco 27
Pressurized infusion control of constellation surgical system 13
Presurgery ocular examination 125
Previous intraocular surgery 183
Pseudoexfoliation 161
Pull nucleus technique 194
Pulse modulation 42
Punctured posterior capsule 161
Q
Quadrant removal 107
R
Radial keratotomy 157, 167
incisions 168f
Refractive
lens exchange 47, 166
in post radial keratotomy 167
lensectomy with 700 micron system 215
Rigid polymethylmethacrylate 171
Ringer's solution 183, 184
Rock-hard nuclei 162
S
Sapphire blades
trapezoid 2.0 to 2.4 mm 85f
trapezoidal shape of 1.8 to 2.2 mm 85f
Scleral tampons 200f
Sclerocorneal incisions 32
Second step in collocation of scleral stoppers 199f
Sensitive phaco dynamics 124
Separation of both cannulas creating nuclear fragmentation 143f
Severe retinal degenerations 53
Shallow anterior chamber 172
Sleeve-less phaco technique 40f
Slim-shaft strong-bevel needle 33
Snellen chart 125
Soft
lenses 29
nucleus outside capsular bag 217f
Stability of anterior chamber 197
Standard 19 gauge phaco needle 80f
Starting micro-biaxial capsulorhexis 216f
Stellaris surgical system 14
Stripping pupillary membrane 166f
Summary of advantages of AMO technology 95
Surgical induced astigmatism 124
Surgically induced astigmatism 53
Suturing of atrophic iris using microincision intraocular forceps 169f
Switching hands 162
T
ThinOptx lens 137f
insertion 137f
Third step in collocation of scleral stoppers 199f
Tipping up nucleus in hydrodissection 135f
Titanium tip excellerator 39f
Torsional ultrasound and microincision cataract surgery 23
Transconjunctival sutureless vitrectomy 197
Trapezoidal
knife with 0.91 to 2 mm 77f
metal blade 149f
Traumatic cataracts 215
Types of cataracts 147
U
Use of spatula 31f
V
Vacuum surge suppressor 177
Valve construction 116t
Vejarano's irrigating chopper 77f, 208
20 gauge with oval lateral holes 148f
22 gauge with rectangular lateral holes 153t
for phakonit 205f
Very shallow anterior chambers 166f
Vigorous hydrosurgery 139
Viscoelastic
cannula 10
entering eye 220f
removal 110
with linear control of flow 110f
Viscosurgical devices 54
Viscous-elastic material aspiration 30t
Visual acuity 125
Vitreous hemorrhage 201f
W
Wide capsulorhexis 140f
Wider phaco needles 20
Wound stability 32
Z
Zonular dialysis 160, 160f, 162f
ZR-1000 IOL 60f
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