By Lucio Buratto, Stephen Brint, Rosalia Sorce
Cataract surgical procedure With Phaco and Femtophaco strategies deals a different perception into the evolution of phacoemulsification machines and the advance of latest how you can provide power, in addition to new units that increase fluidics as a result expanding the security of the phaco and femtophaco surgical procedures.
Dr. Lucio Buratto, Dr. Stephen Brint, and Dr. Rosalia Sorce offer a step by step method of every little thing the physician needs to know about the actual rules that control the fluidics and effort to appreciate the machine’s operating through the surgical procedure.
Cataract surgical procedure With Phaco and Femtophaco concepts covers a wide selection of subject matters, together with anterior chamber phacoemulsification, endocapsular options, irrigation and aspiration, fluidics and pumps, and ideas of femtosecond cataract surgery.
Supplemented through greater than three hundred colour illustrations, diagrams, a word list, and references, all surgeons from newbie to professional will wish this certain source by means of their facet.
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Additional info for Cataract Surgery With Phaco and Femtophaco Techniques
The fragment is thus brought to the pupillary center and emulsified: traction toward the center is performed slowly and gradually and should ideally be supported by the second instrument that helps free the quadrant from adjacent material. Occlusion and emulsification take place with short bursts or pulses of U/S and the material is kept under constant control with the use of the spatula. The best site for occluding the nuclear fragment to be emulsified differs depending on the size and hardness of the nucleus and the size of the capsulorrhexis.
The nucleus is left intact distally. (B) The spatula is inserted from the lateral paracentesis and then the U/S tip is retracted to the limit of the capsulorrhexis. At this point, the pedal goes to zero (thus aspiration and irrigation are disabled) so that the chamber flattens and the nucleus tends to rise in the anterior chamber. (C) The spatula presses at 6 o’clock (or in the direction opposite the main tunnel) and holds the nucleus in place in that area so only the proximal equator detaches from the capsular bag and rises in the anterior chamber in part due to suspension of the irrigation.
Entry to the anterior chamber can be made with a beveldown or bevel-up angled tip. The former is preferable where the chamber is shallow to prevent tearing or detaching the iris with subsequent risk of hemorrhaging and miosis that could compromise the subsequent steps of the procedure. Once the chamber has been entered, the tip is rotated upward. Irrigation is not necessary, as the maneuver must be preceded by the chamber being filled with viscoelastic. The alternative is to make the entry with the phaco tip in the bevel-up position, thus avoiding rotation and therefore formation of folds in the silicone sleeve.