Optimizing refractive lens exchange with bimanual microincision phacoemulsification i. Bimanual femtosecond laserassisted cataract surgery with microincisions was performed on 80 eyes group a with the lowenergy ziemer ldv z8. Section i phaco, microphaco, microcoaxial phaco, biaxial phaco, torsional phaco and manual small incision cataract surgery video i history and use of ophthalmic anesthesia jorge l alio, martin dittman, juan l gonzalez spain video ii pearls in converting to topical anesthesia in phacoemulsification. Hydrodynamic analysis and irrigation device design for the. The choppers retract the capsular rim so they can catch the equator and are brought together centrally to create. At the same time, id like to start to talk about smaller incisions that might be utilized some day with smaller incision lenses. This allows smaller incision sizes than conventional phacoemulsification. Some phaco systems incorporate additional optional functionalities, often as ancillary modules, to perform related procedures such as ultrasonic capsulotomy, bipolar diathermy, andor anterior vitrectomy. The primary concern with ultrasound has always been the risk of wound burn. Coaxial microincision cataract surgery versus standard coaxial. Steve shearing, md, wrote about it almost 20 years ago.
Utilizing aggressive hydrodelineation, the nucleus is. Rather than make the paracentesis incisions freehand with a super blade, surgeons performing their first few bimanual cases should use a keratome that is sized to automatically create a 1. The next thing i would like to talk about is bimanual phacoemulsification, because i think it was an outgrowth of trying to improve on fluidics. The system is designed for use in both anterior and posterior segment surgeries. View bausch and lomb storz ophthalmics product sets for our wide range of surgical products offered on the storz eye website. Mastering the tools and techniques of phacoemulsification surgery, fourth edition pdf cdrom is the complete text, including all images and.
Storz phaco manual on pdf database products for storzbausch lomb phaco systems. Hydrodynamic analysis and irrigation device design for the coaxial and bimanual phacoemulsification techniques in cataract surgery 125 correspondingly, the flow rate can be established for various. Mark packer demonstrates bimanual phacoemulsification in the case of moderately dense nuclear sclerosis. Phaco chop is a bimanual phacoemulsification technique to remove cataracts. This has now been accepted as gold standard surgical.
Agarwals eye hospital in chennai, india, who has pioneered numerous surgical procedures, including bimanual phaco. Bimanual, ultrasmall incision cataract surgery and companion iol. Mastering techniques optimizing technology and avoiding complications pdf. Aspiration of residual cortical matter, especially if located in the subincisional area, can pose a challenge to the cataract surgeon. The first technique to master is construction of the incision and the second is the formation of the capsulorhexis. When you create the two incisions used in a bimanual technique, make them the same distance apart as youre used to with your usual technique. Eyeworld phacoemulsifications past, present, and future. Principles and techniques, second edition is perfect for the surgeon interested in learning the concepts, developing skills, and preparing for the actual surgical procedure. One hundred percent ultrasound power was required to create a wound burn in the unoccluded mode in continuous ultrasound and the burst mode.
Bimanual phacoemulsification using the balanced phaco tip of centurion. Phacoemulsification is a modern cataract surgery in which the eyes internal lens is emulsified with an ultrasonic handpiece and aspirated from the eye. Due to recent improvements in phacoemulsification techniques, advances in surgical. At that time, bimanual microincision cataract surgery did not gain surgeons interest since there was no available foldable intraocular lenses to be. Bmics is an efficient and safe cataract surgery procedure. Phacoemulsification phacoemulsification, introduced by kelman in 1967, is undoubtedly one of the most important innovations in ophthalmology. In coaxial microincision cataract surgery cmics, irrigation, aspiration, and phacoemulsification are performed with the same instruments, which. Surgery bimanual phacomics written by internationally renowned dr. The best way to manage a wound burn is to avoid creating one, notes amar agarwal, md, director of dr. The technique was first presented at the 1993 3rd americaninternational congress on cataract, iol, and refractive surgery. If one has experience with bimanual phaco, this technique may be particularly advantageous for this situation. A very small no stitch incision is made in the side of the cornea.
Cataract surgeons weigh in on the techniques they love and those they loathe. Rather than make the paracentesis incisions freehand with a super blade, surgeons performing their first few bimanual cases should use a keratome that is sized to automatically create. Ashok garg and his coeditors summarize the current art and science of minimally invasive cataract surgery. Bimanual phacoemulsification through 2 stab incisions. It provides capabilities for phacoemulsification, coaxial and bimanual. Mastering phacoemulsification in difficult situations tanuj dada, jagat ram, prema padmanabhan, haripriya aravind. Other exclusion criteria were intraoperative events like manual. Symmetric bimanual phacofragmentation is a new preslice technique in which the nucleus. Hybrid bimanual technique for aspiration of residual cortex. Phaco chop technique for cataract surgery in the dog. Mastering the art of bimanual microincision phaco phakonit mics ashok garg, i.
Minimally invasive cataract surgery bimanual phacomics. Phaco tips phaco tips you can use the following products with the whitestar signature system, the sovereign and the sovereign compact system. Fiftysix patients of immature senile cataract with hard nucleus grade 3. Bimanual phacoemulsification using the new balanced phaco. Aspirating blue, irrigating pinkish discounts calculated when add to cart button is pushed multiple times. To evaluate the efficacy and postoperative outcomes of bimanual and micro. Its balanced energy technology enhances phaco efficiency through the ozil key features include a bluetooth footpedal, 18inch user interface, and video inlay pulsed, or highpulsed phaco, bimanual or coaxial phaco. After inserting the sheets glide through the phaco incision, the irrigating chopper and bare phaco needle are.
Intraocular pressure during phacoemulsification request pdf. The introduction of ophthalmic viscosurgical devices ovds was a significant improvement, and ovds are important tools in modern phacoemulsification. Aay aq fid22795312 pdfmachine by broadgun software a great pdf writer. New phaco needle decreases leakage to achieve the goal of a mics procedure that can be performed with greater flow and vacuum levels, without incision leakage and a risk of wound burn, dr mackool designed a new phaco needle for bimanual mics mackool bimanual. Section i phaco, microphaco, microcoaxial phaco, biaxial phaco, torsional phaco and manual small incision cataract surgery video i history and use of ophthalmic anesthesia jorge l alio, martin dittman, juan l gonzalez spain video ii pearls in converting to topical anesthesia in phacoemulsification kumar j doctor india. After inserting the sheets glide through the phaco incision, the irrigating chopper and bare phaco. Aspirated fluids are replaced with irrigation of balanced salt solution to maintain the anterior chamber. As a possible alternative to bimanual phaco, 28 percent of the. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Bimanual microincisional cataract surgery technique and clinical. Bimanual femtosecond laserassisted cataract surgery. Surgeons who perform bimanual microincisional phacoemulsification create. What is a adobe portable document format adobe reading free.
Bimanual phaco has actually been around for a long time. Wills easy guitar and other stuff recommended for you. Mastering techniques optimizing technology and avoiding complications epub download. Bimanual phacoemulsification using the balanced phaco tip of. Ccis often are not watertight at the conclusion of cataract surgery and this has been reported to increase the risk of anterior chamber fluid egress. International council of ophthalmologys ophthalmology surgical competency assessment rubric icooscar the international council of ophthalmologys ophthalmology surgical competency. Phacoemulsification with intraocular lens iol implantation. This technique can be safely continued until vitreous is aspirated. The time to create the wound burn was 160 and 180 seconds in 2 eyes in continuous ultrasound and 42 and 50 seconds in 2 eyes in the burst mode. Section i phaco, microphaco, microcoaxial phaco, biaxial. Bimanual phacoemulsificationmics microincision cataract surgery is an emerging alternative to standard coaxial phacoemulsification.
Feasibility of bimanual microincision phacoemulsification. Cataract surgery complications managing residual lens. Hoffman, md, mark packer, md bimanual microincision phacoemulsi. Bimanual phacoemulsification mics microincision cataract surgery is an emerging alternative to standard coaxial phacoemulsification. New techniques and technology enhance benefits of mics. International council of ophthalmologys ophthalmology. Putting it all together reprinted from 2008 ascrs chicago supplement supported by an unrestricted educational grant from alcon, inc.