Date post: | 23-Dec-2014 |
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Health & Medicine |
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INTRODUCTION
It was introduced by Charles Kelman in 1967.Small Incision which in turn reduces
• Healing time• No of sutures• Postoperative astigmatism• Hemorrhagic complications
Conservation of posterior chamber, avoiding retinal detachment, maintaining vitreous.
Complete aspiration of cortex.Easy implantation of IOL.
PRINCIPLES OF PHACOEMULSIFICATION
¤Hardness of the nucleus.¤Red reflex of the fundus.¤Corneal transparency.¤Trophism of iris.¤Chamber depth.¤Pathologies.
FLUID DYNAMICS OF PHACO
► Bottle with irrigation liquid
► An irrigation tube► The eyeball► An aspiration tube► An aspiration
pump
IRRIGATION/ASPIRATION
Irrigation depends on the height of the bottle and thus gravitational force.
Aspiration depends on the type of the pump
Peristaltic.Venturi Diaphragm.
PARTS OF PHACOEMULSIFIER
Machine bodyConnection systemHandle• Ultrasonic probe• I/A hand piece• Diathermy hand
piece
STEPS FOR PHACOEMULSIFICATION
Incision
Limbal Easy to perform, Need sutures.
Scleral(3.5-7mm) Corneal (2.8-4mm)
(4.5-6.5)
CAPSULOTOMY
It is the process of making the incisions around the anterior capsule of the lens. Can opener. Christmas tree. Postage stamp. Envelope. Capsulorhexis.
DIVIDE AND CONQUER
Nucleus is separated into 4 pieces.
Each pieces are emulsified separately.
Easy to do but need lots of ultrasonic power.
STOP AND CHOP
Formation of groove.Nucleus is break into two halves.Easy to do.Less ultrasonic power.Need two hands.
IRRIGATION/ASPIRATION
The amount of irrigation flow depends on:Diameter of the
irrigating tubeDiameter of the
connectionsSize of the orifices in the
tipHeight of the irrigating
bottle
The aspiration depends on:Diameter of the tube and
orificesLevel of vacuum set on the machine
Type of pump used.