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Phacoaspiration in congenital cataract

Poster Details

First Author: O.Fechin RUSSIA

Co Author(s):                  

Abstract Details



Purpose:

Specific features of congenital cataracts in children such as elasticity and thickness variability of the anterior capsule, soft lens substance and absence of dense nucleus are well known. Nowadays standard technique of soft cataract removal in children includes lens material removal using aspiration-irrigation method. Removal of lens material with aspiration-irrigation is hydrodissection; that is, lens material is mixed with saline solution and aspirated. Nevertheless, this technique has the following drawbacks. Viscoelastic is frequently aspirated which requires its additional injection into the anterior chamber. Use of irrigation results in an increase of fluid volume passing through the anterior chamber, thus increasing the risk of endothelium damage and time of operation. Aim. To reduce traumaticity and time of operation and to develop more effective technology of lens material; removal using aspiration only (without irrigation).

Setting:

Eye Microsurgery Center, Ekaterinburg, Russia

Methods:

The suggested technology includes a sequence of minimal number of actions compared to aspiration-irrigation technique. Viscoelastic injected into the anterior chamber is a lid closing lens material in capsulorhexis zone. Under this lid it becomes possible to perform aspiration of lens material quickly and safely without irrigation. Aspiration starts from the equatorial zone of the lens with a cannula inserted through the main tunnel incision. In one pass lens material is aspirated along the entire equator with circular motion of the cannula. Only at the final step lens material is aspirated from the central zone of the lens. At this moment the distal end of the cannula is placed at the equator, sliding upon the posterior capsule with aspiration hole upwards. During all the steps of operation viscoelastic should be prevented from aspiration into the cannula. It is possible due to use of transparent polymer cannula and visual control by the surgeon. The technique of operation is as follows. Corneal tunnel incision 1.0 - 2.2 mm long is performed; CCC is performed with a collet forceps. Lens removal is performed as described. An IOL is implanted into the capsular bag if axial length is over 21 mm.

Results:

In our clinic 46 operations for congenital cataract has been performed in children aged from 3 months to 16 years. All the operations were uneventful. Operation time was reduced due to shorter step of aspiration.

Conclusions:

The suggested technology results in reduction of operation trauma and surgery time, quicker rehabilitation of the patients. The technology may be successfully used in congenital lens ectopia, i.e. Marfan's syndrome, microspherophakia, where weak Zinn's zonulae are present and leaking of irrigation fluid into the retrolental space is possible. FINANCIAL INTEREST: NONE

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