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MICRO-BIAXIAL PRECHOP AT THE IRIS PLANE. Arturo Pèrez -Arteaga M.D. Medical Director, Centro Oftalmològico Tlalnepantla, Mèxico . Poster Presentation , ASCRS meeting . Boston, 2010. FINANTIAL DISCLOSURE. I HAVE NO FINANTIAL INTERESTS OR RELATIONSHIPS TO DISCLOSE. Purpose.
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MICRO-BIAXIAL PRECHOP AT THE IRIS PLANE Arturo Pèrez-Arteaga M.D. Medical Director, Centro Oftalmològico Tlalnepantla, Mèxico. Poster Presentation, ASCRS meeting. Boston, 2010.
FINANTIAL DISCLOSURE I HAVE NO FINANTIAL INTERESTS OR RELATIONSHIPS TO DISCLOSE
Purpose Todemonstrate the safety and efficacy of performing pre-chop at the iris plane in a bi-axial mode.
Advantages of Prechopping • DecreasesthePhaco Time and Power. • Uses mechanicalforcesinstead of ultrasound. • FacilitatesPhacoemulsification. • Improvesfollowability. • Decreasestheforceappliedto capsular tissues. • Decreases total surgical time.
Comparison of twoFragmentationsites Insidethe Capsular Bag Outsidethe Capsular Bag Towork at theiris planedecreasesthe Capsular and Zonular Trauma
Bi-Axial Prechoppingwithtwo 25G Cannulas (BAPC25G) • It uses onlytwoviscoelasticcannulastofragmentatethenucleus. • Thefragmentationisoutsidethe capsular bag withthe “Lens Salute Technique”. It uses the Iris Plane. • It uses a Bi-Axial approachwithtwocannulas “facetoface”.
WideCapsulorrhexis. VigorousHydrosurgery. Nucleus placed in “Lens Salute Position”. Intraocular tissuesprotectedwithviscoelastic. Cannulasintroduced at 120 to 180 degrees. Forceappliedbetweentwocannulas, to fracture thenucleus at the iris plane. Multiplefragmentations. Phaco as usual. SURGICAL TECHNIQUE. BIAXIAL PRECHOP 25 G
ComparisonStudyBetweenTechniques. 200 eyes, onesurgeon, 8 monhts, intraoperative and postoperative records. Prechopp at the Capsular Bag. Forceps & Choppers. ComparativeGroup, 100 e. Retrospectivereview. Bi-Axial Prechop.Irisplane. Two 25 G Cannulas. Experimental Group. 100e. Prospective data. • Total surgical time • Corneal edema • Phacopower & time • Time of visual recovery. • Final visual outcome • SIXCASES OF CAPSULAR DAMAGE. • Total surgical time • Corneal edema • Phacopower & time • Time of visual recovery • Final visual outcome • TWOCASE OF CAPSULAR DAMAGE
Conclusion Biaxial Prechopwith 25 G Cannulas • Wewerenotableto determine ifthemoment of capsular damagewasduringtheprechopmaneuver. • Wejustdid a comparison of capsular damagewhileperformingbothtechniques
Conclusion Biaxial Prechopwith 25 G Cannulas • Itis a safe and effectivemethodto produce mechanicalfragmentation. • Itdecreasestheforcesappliedtothe capsular bag and thezonula. • Itiscost-effectivebecauseitavoidsexpensiveinstrumentation
Conclusion Biaxial Prechopwith 25 G Cannulas • It can beuseful as a method of nuclear fragmentationformanyotherlensextractiontechniques (Bi-Axial Phaco, Co-Axial Phaco, Manual Phacofragmentationtechniques) • Itisnot exclusive of Bi-Axial Techniques.