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First Author: G.Parkhomenko UKRAINE
Co Author(s): N. Torchinska S. Medvedchuk A. Kovalenko V. Skopa
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Optimization of surgical technique in combination of laser assisted cataract surgery LenSx and implantation of EX-PRESS mini shunt with the objective of prophylaxis of intraoperative myosis.
Ophthalmological clinic "New Vision", Kiev, Ukraine
We performed 5 combined surgeries in 5 patients having combination of cataract and primary open angle glaucoma. Implantation of mini shunt EX-PRESS (Alcon) with the inner diameter of 50 mkm was performed as antiglaucomatous surgery. During phacoemulsification anterior curvilinear capsulorhexis, lens fragmentation and self-sealing clear corneal incisions were performed on femtosecond laser LenSx (Alcon), removing of lens fragments was carried out with the help of phaco machine Infiniti Vision System (Alcon). The peculiarities of surgical technique were the following: immediate transportation of the patient to the operating theater after performing of laser stage of surgery, completion of cataract removal and intraocular lens implantation after femtosecond laser stage before performing of antiglaucomatous surgery stage, formation of scleral superficial flap and implantation of EX-PRESS mini shunt (Alcon) as finalizing stage of surgery under condition of appropriate intraocular pressure achieved by injecting of Provisc (Alcon) in anterior chamber.
In all five cases of combined surgery the stages of capsulorhexis, lens fragmentation, formation of clear corneal incisions with the help of femtosecond laser were performed without complications. Removing of anterior capsule and fragmented nucleus after patients transportation to the operating theatre were carried out without complications with sufficient mydriasis.
It is appropriate to decrease maximally the time interval between laser and surgical step and to perform antiglaucomatous stage after finalizing of phacoemulsofocation and intraocular lens implantation for prophylaxis of intraoperative myosis in cases of combined surgery in patients with cataract and glaucoma.