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PubMed · 15474811

Phaco rolling technique.

Jose L Güell·Mercedes Vázquez·Jose Lucena·Fortino Velasco·Felicidad Manero
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Abstract

We describe a phacoemulsification technique for soft and medium-hard cataracts to decrease phaco time and enhance the safety of the procedure. After conventional hydrodissection and hydrodelamination are performed, a 15- or 30-degree phaco tip is positioned on the peripheral lens beside the capsulorhexis edge and in contact with the nucleus-epinucleus interface. The lens is then aspirated onto the phaco tip. Phacoemulsification is started with the ultrasound energy level limited to 15% to 25% depending on the nuclear hardness and with linear aspiration power up to 250 mmHg. The phaco tip is slightly displaced to the vertex of the pupil to keep it occluded, and the lens is rotated. The phaco tip is placed in the same area and a modified manipulator used to keep the lens in a horizontal position during rotational movement. The small, hard, central nucleus is usually emulsified at the end.

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CapsulorhexisHumansPhacoemulsificationJournal Article

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Jose L Güell, Mercedes Vázquez, Jose Lucena, Fortino Velasco, Felicidad Manero. 2004. Phaco rolling technique.. https://doi.org/10.1016/j.jcrs.2004.05.005

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PubMed2005

Closed chamber globe stabilization and needle capsulorhexis using irrigation hand piece of bimanual irrigation and aspiration system.

BACKGROUND: The prerequisites for a good capsulorhexis include a deep, well maintained anterior chamber, globe stabilization and globe manipulation. This helps to achieve a capsulorhexis of optimal size, shape and obtain the best possible position for a red glow under retroillumination. We report the use of irrigation handpiece of bimanual irrigation aspiration system to stabilize the globe, maintain a deep anterior chamber and manipulate the globe to a position of optimal red reflex during needle capsulorhexis in phacoemulsification. METHODS: Two side ports are made with 20 G MVR 'V' lance knife (Alcon, USA). The irrigation handpiece with irrigation on is introduced into the anterior chamber through one side port and the 26-G cystitome (made from 26-G needle) is introduced through the other. The capsolurhexis is completed with the needle. RESULTS: Needle capsulorhexis with this technique was used in 30 cases of uncomplicated immature senile cataracts. 10 cases were done under peribulbar anaesthesia and 20 under topical anaesthesia. A complete capsulorhexis was achieved in all cases. CONCLUSION: The irrigating handpiece maintains deep anterior chamber, stabilizes the globe, facilitates pupillary dilatation, and helps in maintaining the eye in the position with optimal red reflex during needle capsulorhexis. This technique is a safe and effective way to perform needle capsulorhexis.

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PubMed2005

Postage stamp multiple anterior capsulorhexisotomies in pediatric cataract surgery.

BACKGROUND: Capsule related complications are common following pediatric cataract surgery. We report a new technique of multiple anterior capsulorhexisotomies after lens aspiration and intraocular lens (IOL) implantation. METHODS: After performing automated lens aspiration, an IOL was implanted into the capsular bag. A bent 26 gauge needle was introduced through one side port and multiple small cuts were made in one half of the circumference of the anterior capsular rim by making a radial movement of the needle tip centripetally over the margin of the anterior capsular rim. The needle was again introduced through the other side port and multiple similar cuts were made in the other half thereby creating nearly 20 - 30 cuts at the margin of the anterior capsular rim. RESULTS: The mean size of the primary capsulorhexis was 4.33 +/- 0.20 mm. A uniform enlargement of the capsulorhexis could be performed in all the eyes without peripheral extension in any of the eyes. There was no damage to the posterior capsule and no scratch mark on the IOL. In one eye, the primary capsulorhexis was slightly eccentric, though it was covering the IOL optic all around. The rhexisotomies in this eye were limited to the capsular rim that was overlapping more on the IOL optic (sectoral anterior capsulorhexisotomies). CONCLUSION: The technique of postage stamp anterior capsulorhexisotomies is a feasible technique in pediatric cataracts.

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