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Occlusion Controlled Phaco and Shallow Anterior Chamber. Dr. Bekir Sıtkı Aslan TOBB ETU Hospital Ankara Turkey. Financial Interest-Alcon Speakers Bureau. Purpose. Cataracts with shallow anterior chamber is a challenge for surgeons, due to lacking space.
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Occlusion Controlled Phaco and Shallow Anterior Chamber Dr. Bekir Sıtkı Aslan TOBB ETU Hospital Ankara Turkey Financial Interest-AlconSpeakersBureau
Purpose • Cataracts with shallow anterior chamber is a challenge for surgeons, due to lacking space. • Anterior chamber fluctuation may contribute to increase the fragility of the tissues in the anterior chamber. • We looked the added benefits of “Occlusion Controlled Phaco” in cataracts with a shallow chamber.
Methods • Prospective analysis of 12 cases with cataracts of varying density and shallow anterior chambers • Patients anterior chambers 2.0mms ≤ were assigned. • Anterior chambers were measured with immersion A-scan. • All cases were operated with torsional energy with vacuum sensitive longitudinal energy delivery.
Methods • Videoanalysis; • Configurationof incision, • The nucleus removal times, • Amount of energy dispersed, • Amount of fluid used, • Number of surges during nucleus removal were recorded. • Pre and post operative visual acuities and eye pressures , cornealedemaand iris defects were noted.
CataractSurgery Challenge • Woundconstruction, • Capsulorhexis, • EndothelialTrauma CataractSurgery Challenge-Control • Smallerwoundconstruction, • Viscoadaptiveuseforcapsulorhexis, • Occlusion Controlled Phaco forEndothelialTrauma ( A smallpercent of vacuumsensitiveLongitudinalenergy is addedtopushbackthenuclearmaterialwhentheshearingactivitystopswith torsional because of occlusion.)
Conclusions • Immatureentryintothe Anterior Chambermayleadtoshortertunnels, • Previoussurgery and acuteangleclosuremayjeopordizeendothelialresistance, • Iristrauma is inevitable in caseswithshallower anterior chambers, • Vitreous tap may be neededif anterior chambercannot be deepenedwithviscoadaptiveviscoelastics, • Lowflow, lowinfusionbottleyieldssuccesful lens removalwithveryacceptableenergy and fluiduse, • Goodvisualoutcomes can be achieved, • Eyepressureshavethetendancytodropwhereassomeslightpressureriseshould be controlledwithtopicalantiglaucomatousdrops.