Toprak Ibrahim, Yaylali Volkan
Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
Case Rep Med. 2019 Jan 27;2019:9043417. doi: 10.1155/2019/9043417. eCollection 2019.
This report describes two maneuvers in different steps of phaco surgery in a case with hard cataract, which provide debulking of the central dense nucleus and prevents posterior capsule rupture (PCR). In the current case, clear corneal incisions were created, and anterior chamber was filled with ophthalmic viscosurgical device (OVD). Anterior capsule was punctured, and capsulorhexis was completed. Nucleus was cracked into two halves following vertical groove formation. Core nucleus was hollowed sideward bilaterally in the capsular bag. Nuclear halves were removed from capsular bag, and each one was pushed to one side on the iris plane. Capsular bag was inflated with OVD, and intraocular lens (IOL) was implanted. Nuclear halves were removed in confidence. The presented maneuvers initially reduce dense nucleus load in the safe zone and allow surgeon to use IOL as a barrier to protect floppy posterior capsule from early steps of the surgery.
本报告描述了在一例硬核白内障病例的超声乳化手术不同步骤中的两种操作方法，这两种方法可使中央致密核块体积减小，并防止后囊破裂（PCR）。在当前病例中，制作了透明角膜切口，前房注入眼科粘弹剂（OVD）。穿刺前囊并完成连续环形撕囊。在形成垂直沟后，将核劈为两半。在囊袋内将核心核向两侧掏空。将核的两半从囊袋中取出，分别推至虹膜平面的一侧。用OVD使囊袋充盈，并植入人工晶状体（IOL）。然后放心地取出核的两半。所介绍的操作方法首先在安全区域减轻了致密核的负荷，并使手术医生能够将人工晶状体用作屏障，以保护松弛的后囊在手术早期不受损伤。
