By Lucio Buratto MD, Stephen Brint MD, Luigi Caretti MD
Dr. Lucio Buratto; Dr. Stephen Brint; and Dr. Luigi Caretti supply step by step method of facilitate how one can investigate the sufferer, practice the method, and supervisor the main not easy cataract surgical procedure complex instances dealing with either starting and skilled surgeons.
Cataract surgical procedure in complex circumstances covers a large choice of subject matters together with cataract in excessive myopia, floppy iris syndrome, aggravating cataract, phacoemulsification with a small scholar, and IOL rationalization and replacement.
Supplemented through greater than 250 colour illustrations, diagrams, a word list, and references, all surgeons, from newbie to professional will wish this precise source via their side.
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Extra resources for Cataract Surgery in Complicated Cases
Divide and conquer nucleofractis phacoemulsification: development and variations. J Cataract Refract Surg. 1991;17(3):281-291. Nagahara K. Video presentation. Presented at: American Society of Cataract and Refractive Surgery Film Festival; 1993; Seattle, WA. Ursell PG, Spalton DJ, Pande MV, et al. Relationship between intraocular lens biomaterials and posterior capsule opacification. J Cataract Refract Surg. 1998;24(3):352-360. Hollick EJ, Spalton DJ, Ursell PG, et al. The effect of polymethylmethacrylate, silicone, and polyacrylic intraocular lenses on posterior capsular opacification 3 years after cataract surgery.
56 This maneuver, only possible in eyes after a trabeculectomy (not a deep sclerectomy), can be performed in eyes with a poorly filtering bleb prior to phacoemulsification. Generally, coaxial microincision cataract surgery (C-MICS) incisions, if performed correctly, do not require sutures. It is advisable to place a single nylon 10-0 suture in the following situations: When there is intraoperative tendency for iris prolapse ● ● Irrigation/Aspiration ● Cortical removal requires careful attention, particularly with loose zonules, where the surgeon may opt to implant a CTR.
The choice of implant must take special conditions into consideration. Pseudoexfoliation with its risk of phimosis of the anterior capsule, suggests implantation of lenses with PMMA haptics, providing greater resistance to capsular contraction. Silicone IOLs should be avoided as they create greater stimulation of capsular contraction (see Chapter 4). In short eyes with IOLs of high dioptric power, a double or piggyback lens may be required so that the sum of the 2 powers is equivalent to the total power needed (see Chapter 9).