Antunes Victor Andrighetti Coronado, Rosatelli Neto José de Mello, Moscovici Bernardo Kaplan, Rabelo Daniel Filipe Oliveira, Sano Victor Akio, Hida Richard Yudi
Instituto de Olhos de Assis (IOA), Assis, São Paulo, Brazil.
Department of Ophthalmology and Visual Sciences, Federal University of São Paulo (UNIFESP), São Paulo, São Paulo, Brazil.
Clin Ophthalmol. 2024 Jul 1;18:1915-1920. doi: 10.2147/OPTH.S465837. eCollection 2024.
We describe an alternative automated technique that consists of simultaneous anterior capsule puncture and decompression of the capsular bag by using an insulin needle attached to the aspiration tubing of the phacoemulsification device to prevent the occurrence of the "Argentinian Flag sign" during capsulorhexis in intumescent cataract.
Instituto de Olhos de Assis and Center of Specialties Hoftalmed, located in the state of São Paulo, Brazil.
Prospective interventional study.
Eighty-eight eyes of 88 patients with white or intumescent cataracts were included in this study. Routine clear cornea incision, capsule staining with trypan blue, intracameral anesthesia, and ophthalmic viscoelastic device were used before the procedure. A 26-gauge needle was connected to the phacoemulsification aspiration tubing using a double male Luer connector for irrigation, and aspiration was inserted into the anterior chamber through a new paracentesis incision with the bevel facing down. Immediately after insertion, automated aspiration of the liquefied cortex was performed to remove anterior intralenticular material and achieve capsular decompression. Compression of the nucleus with the needle tip was performed to remove any liquefied material trapped between the posterior surface of the nucleus and the posterior capsule. All surgeries were performed using the same phacoemulsification and parameters. The rate of complete continuous capsulorhexis was observed and noted.
No complications were observed in any of the cases. A single-stage, continuous, and well-centered capsulorhexis was achieved in 100% of cases.
We conclude that a simultaneous puncture and decompression of the capsular bag using an insulin needle attached to the aspiration tubing of the phacoemulsification machine effectively avoided the "Argentinian Flag sign" in intumescent cataract surgery.
我们描述了一种替代性自动化技术，该技术通过使用连接到超声乳化设备抽吸管道的胰岛素针同时进行前囊穿刺和囊袋减压，以防止膨胀期白内障撕囊过程中出现“阿根廷国旗征”。
位于巴西圣保罗州的阿西斯眼科研究所和霍夫塔尔梅德专科中心。
前瞻性干预性研究。
本研究纳入了88例患有白色或膨胀期白内障患者的88只眼。手术前常规行透明角膜切口、用台盼蓝进行囊膜染色、前房内麻醉并使用眼科粘弹剂。使用双阳鲁尔接头将一根26号针连接到超声乳化抽吸管道用于冲洗，然后将抽吸针通过一个新的侧切口插入前房，斜面朝下。插入后立即自动抽吸液化的皮质，以清除晶状体前房内的物质并实现囊袋减压。用针尖压迫核，以清除被困在核后表面和后囊之间的任何液化物质。所有手术均使用相同的超声乳化设备和参数。观察并记录完全连续撕囊的发生率。
所有病例均未观察到并发症。100%的病例实现了单阶段、连续且居中良好的撕囊。
我们得出结论，在膨胀期白内障手术中，使用连接到超声乳化机抽吸管道的胰岛素针同时进行囊袋穿刺和减压可有效避免“阿根廷国旗征”。
