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Chapter-17 Phacoemulsification

BOOK TITLE: Clinical Ophthalmology: Medical and Surgical Approach

Author
1. Doctor Kumar J
ISBN
9789350250044
DOI
10.5005/jp/books/11246_17
Edition
2/e
Publishing Year
2011
Pages
34
Author Affiliations
1. Doctor Eye Institute, Spenta Mansion, Ist floor, SV Road, Andher (W), Mumbai, Doctor Eye Institute, Mumbai, India, Doctor Eye Institute, Spenta Mansion, SV Road, Andheri (West) Mumbai, India, Doctor Eye Institute, Spenta Mansion, 1st Floor, SV Road, Andheri (West), Mumbai, India, Doctor Eye Institute, Spenta Mansion, SV Road, Andheri (West), Mumbai, India, Doctor Eye Institute, Spenta Mansion, SV Road, Andheri (W), Mumbai, India, Doctor Eye Institute Pvt Ltd Spenta Mansion, Mumbai, Doctor Eye Institute, Spenta Mansion, 1st Floor, S.V. Road, Andheri (West), Mumbai, India, 11F No 369 Sec 2 Chang Gung Rd. Nei-Hu, Doctor Eye Institute, Spenta Mansion,1st floor, SV Road, Andheri (W), Mumbai 400 058, Doctor Eye Institute, Spenta Mansion SV Road, Andheri (W), Mumbai-400058, India, Doctor Eye Institute, Spenta Mansion, SV Road, Andheri (West), Mumbai-400058, Maharashtra, India, Doctor Eye Institute, Spenta Mansion, First Floor, SV Road, Andheri (West), Mumbai, India, Doctor Eye Institute Spenta Mansion, 1st Floor SV
Chapter keywords

Abstract

Cataract surgery is uniquely demanding and ever-changing. Over the last few decades, ophthalmology has witnessed profound technological advancements, adding new qualitative dimensions to cataract surgery. Charles Kelman, with his invention of ultrasound phacoemulsification, virtually trans­formed cataract surgery. With revolution in technology, there has to be evolution in technique to make the procedure safe, easy and reproducible—“a quantum leap towards perfection”. Endocapsular phacoemulsification with nucleus cleavage is currently one of the most favored techniques of phacoemulsi­fication as this has greatly increased the safety of the phaco procedure. Techniques of endocapsular phacoemulsification with nucleus cleavage include “the chip and flip technique” and its variant the “spring surgery”. This technique for in-the-bag phacoemulsification, which allows the phacoemulsification tip to be consistently far away from the posterior capsule thus increasing safety and control for phacoemulsification. Nucleus emulsification involving the various cracking techni­ques is a great leap in safe phacoemulsification. With soft nuclei, the “chip and flip” technique enables limited traction to be exerted on the capsular bag. With moderate or hard nuclei, when it is necessary to use cracking techniques, the Kelman’s V technique limits the need for rotating the nucleus and may prove especially useful. In general, phaco­emulsification in these situations may be considered a safe alternative if performed by low vacuum, low aspiration and low infusion.

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