Aay aq fid22795312 pdfmachine by broadgun software a great pdf writer. Aspirated fluids are replaced with irrigation of balanced salt solution to maintain the anterior chamber. Symmetric bimanual phacofragmentation is a new preslice technique in which the nucleus. Other exclusion criteria were intraoperative events like manual. Section i phaco, microphaco, microcoaxial phaco, biaxial.
After inserting the sheets glide through the phaco incision, the irrigating chopper and bare phaco. Bimanual femtosecond laserassisted cataract surgery with microincisions was performed on 80 eyes group a with the lowenergy ziemer ldv z8. Bimanual phacoemulsificationmics microincision cataract surgery is an emerging alternative to standard coaxial phacoemulsification. At the same time, id like to start to talk about smaller incisions that might be utilized some day with smaller incision lenses. At that time, bimanual microincision cataract surgery did not gain surgeons interest since there was no available foldable intraocular lenses to be. Mastering the tools and techniques of phacoemulsification surgery, fourth edition pdf cdrom is the complete text, including all images and. Ashok garg and his coeditors summarize the current art and science of minimally invasive cataract surgery. Coaxial microincision cataract surgery versus standard coaxial. Aspiration of residual cortical matter, especially if located in the subincisional area, can pose a challenge to the cataract surgeon. To evaluate the efficacy and postoperative outcomes of bimanual and micro. Bimanual microincision cataract surgery versus coaxial. Intraocular pressure during phacoemulsification request pdf. Bimanual phaco has actually been around for a long time.
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. 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. Intraocular pressure was measured during bimanual microphaco through 2 different incision sizes and with and without the cruise control staar surgical. 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. Bimanual phacoemulsification through 2 stab incisions. Mastering techniques optimizing technology and avoiding complications pdf. Fiftysix patients of immature senile cataract with hard nucleus grade 3. Eyeworld phacoemulsifications past, present, and future. The introduction of ophthalmic viscosurgical devices ovds was a significant improvement, and ovds are important tools in modern phacoemulsification. The choppers retract the capsular rim so they can catch the equator and are brought together centrally to create.
Phacoemulsification is a modern cataract surgery in which the eyes internal lens is emulsified with an ultrasonic handpiece and aspirated from the eye. This has now been accepted as gold standard surgical. As a possible alternative to bimanual phaco, 28 percent of the. 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. Optimizing refractive lens exchange with bimanual microincision phacoemulsification i. The technique was first presented at the 1993 3rd americaninternational congress on cataract, iol, and refractive surgery. Bimanual, ultrasmall incision cataract surgery and companion iol.
Mastering techniques optimizing technology and avoiding complications epub download. Hydrodynamic analysis and irrigation device design for the. This technique can be safely continued until vitreous is aspirated. 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. 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. Due to recent improvements in phacoemulsification techniques, advances in surgical.
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. The system is designed for use in both anterior and posterior segment surgeries. Chad bouterse, do, presents a bimanual cataract surgery. Mark packer demonstrates bimanual phacoemulsification in the case of moderately dense nuclear sclerosis. This technique became popularized as bimanual phaco, microincision cataract surgery mics or.
Phaco chop is a bimanual phacoemulsification technique to remove cataracts. What is a adobe portable document format adobe reading free. Ultrasound phacoemulsification with implantation of a foldable intraocular lens iol has become the method of choice today in cataract surgery leaming 2004. Phacoemulsification phacoemulsification, introduced by kelman in 1967, is undoubtedly one of the most important innovations in ophthalmology. Agarwals eye hospital in chennai, india, who has pioneered numerous surgical procedures, including bimanual phaco. Mastering phacoemulsification in difficult situations tanuj dada, jagat ram, prema padmanabhan, haripriya aravind.
Phaco tips phaco tips you can use the following products with the whitestar signature system, the sovereign and the sovereign compact system. International council of ophthalmologys ophthalmology. Amar agarwal is the pioneer of phakonit which is phako with a needle incision technology. This allows smaller incision sizes than conventional phacoemulsification. Steve shearing, md, wrote about it almost 20 years ago. 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. Bmics is an efficient and safe cataract surgery procedure. Phaco chop technique for cataract surgery in the dog.
Bimanual phacoemulsification using the new balanced phaco. 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. To benefit from the advantages offered by bimanual microincisional phacoemulsification, surgeons must pay strict attention to detail. Bimanual microincisional cataract surgery technique and clinical. New techniques and technology enhance benefits of mics. International council of ophthalmologys ophthalmology surgical competency assessment rubric icooscar the international council of ophthalmologys ophthalmology surgical competency. Hoffman, md, mark packer, md bimanual microincision phacoemulsi. In coaxial microincision cataract surgery cmics, irrigation, aspiration, and phacoemulsification are performed with the same instruments, which. Minimally invasive cataract surgery bimanual phacomics. Putting it all together reprinted from 2008 ascrs chicago supplement supported by an unrestricted educational grant from alcon, inc. Principles and techniques, second edition is perfect for the surgeon interested in learning the concepts, developing skills, and preparing for the actual surgical procedure. Disposable metal keratomes are an adequate choice, or a. Surgeons who perform bimanual microincisional phacoemulsification create.
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. Utilizing aggressive hydrodelineation, the nucleus is. Hybrid bimanual technique for aspiration of residual cortex. View bausch and lomb storz ophthalmics product sets for our wide range of surgical products offered on the storz eye website. Micro coaxial cataract surgery where quality meets innovation to optimize outcomes in sub 2. It provides capabilities for phacoemulsification, coaxial and bimanual. Storz phaco manual on pdf database products for storzbausch lomb phaco systems. The first technique to master is construction of the incision and the second is the formation of the capsulorhexis. Mastering the art of bimanual microincision phaco phakonit mics ashok garg, i.
Bimanual phacoemulsification using the balanced phaco tip of. Bimanual phacoemulsification using the balanced phaco tip of centurion. One hundred percent ultrasound power was required to create a wound burn in the unoccluded mode in continuous ultrasound and the burst mode. Aspirating blue, irrigating pinkish discounts calculated when add to cart button is pushed multiple times. Feasibility of bimanual microincision phacoemulsification. Wills easy guitar and other stuff recommended for you. Cataract surgeons weigh in on the techniques they love and those they loathe. Phacoemulsification with intraocular lens iol implantation. Bimanual femtosecond laserassisted cataract surgery. If one has experience with bimanual phaco, this technique may be particularly advantageous for this situation. This completely revised and updated resource contains a detailed description of the basic technique of phacoemulsification. Quantitative measurement of wound architecture in microincision cataract surgery. The primary concern with ultrasound has always been the risk of wound burn.
Some phaco systems incorporate additional optional functionalities, often as ancillary modules, to perform related procedures such as ultrasonic capsulotomy, bipolar diathermy, andor anterior vitrectomy. Bimanual phacoemulsification mics microincision cataract surgery is an emerging alternative to standard coaxial phacoemulsification. 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. Cataract surgery complications managing residual lens. Surgery bimanual phacomics written by internationally renowned dr. Such an incision promotes fast and more comfortable recovery 2. A very small no stitch incision is made in the side of the cornea.
1338 1351 143 551 453 334 254 534 1119 1435 992 1125 328 117 44 1466 465 45 702 1257 865 1542 188 55 598 1077 1506 990 162 646 10 1361 993 1086 1450 598 437 214 1262