gms | German Medical Science

22. Internationaler Kongress der Deutschen Ophthalmochirurgen

18. bis 21.06.2009, Nürnberg

A complex approach in prevention of complications during phaco in patients with pseudoexfoliation syndrome

Meeting Abstract

  • Oleg Shilovskikh - S. Fyodorov Eye Microsurgery Federal State Institution, Ekaterinburg Branch, Ekaterinburg, Russia
  • Boris Laptev - S. Fyodorov Eye Microsurgery Federal State Institution, Ekaterinburg Branch, Ekaterinburg, Russia
  • Oleg Fechin - S. Fyodorov Eye Microsurgery Federal State Institution, Ekaterinburg Branch, Ekaterinburg, Russia
  • Alexey Ulyanov - S. Fyodorov Eye Microsurgery Federal State Institution, Ekaterinburg Branch, Ekaterinburg, Russia

22. Internationaler Kongress der Deutschen Ophthalmochirurgen. Nürnberg, 18.-21.06.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09docWK 3a.7

DOI: 10.3205/09doc107, URN: urn:nbn:de:0183-09doc1072

Veröffentlicht: 9. Juli 2009

© 2009 Shilovskikh et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Purpose: To develop a complex approach in prevention of complications during phaco in patients with pseudoexfoliation syndrome.

Patients and methods: MICS was performed in 172 eyes of 150 patients. All the patients had PEX. Mean BCVA before surgery was 0.1. Intraocular pressure was 16.5 mm Hg. Mean pupil diameter after medical dilation was 4.0 mm. A complex of measures for prevention of complications was performed in all patients and included implantation of pupil retractor (Malyugin ring); capsulorhexis was performed at the edge of dilated pupil and then capsulorhexis and iris were fixed with pupil dilator hinges. Thus the capsular bag was fixed to the pupil edge limiting liquid flow beneath the iris.

Hydrodissection was performed with a bent cannula 0.4 mm in diameter. A minimal dosed amount of fluid was used.

Phaco was performed with INTREPID technology using low parameters of bottle height and irrigation, with a possibility to decrease the influence of hydrodynamic flows on the weakened zonule. During aspiration of residual cortex possible zonule defects were found out. In this case an intracapsular ring with a provisory 10-0 thread was implanted.

Results: In 161 case iridocapsular fixation remained stable till the end of surgery. In 11 cases capsular bag was removed due to complete insufficiency of the zonule. Mean visual acuity was 0.5, IOP was 13.5 mm Hg.

Conclusion: The suggested complex approach provides a possibility to perform phaco effectively in patients with pseudoexfoliation syndrome. The technique ensures the influence of turbulent fluid flows on the zonule.