Official ESCRS | European Society of Cataract & Refractive Surgeons

Endothelial protection by closed eye repositioning of anterior capsule .(E.P.A.C.) Personal technique of phacoemulsification

Session Details

Session Title: Cataract 2
Session Date/Time: Saturday 21/02/2015 | 08:30-11:00
Paper Time: 10:09
Venue: Hall 1
First Author: : G.La Rocca ITALY
Co Author(s): :    G. Corsani              

Abstract Details


This technique requires that the anterior capsule must be flat and positioned in the superior part of the anterior chamber,after capsulorexis , to protect the corneal endothelial cells during phacoemusification. It is indicated for hard cataracts ,shallow anterior chambers and Fuchs' distrofies.


Ophthalmic Department ,Nuovo Ospedale S.Stefano ,Prato ,Italy


The surgical steps which are mandatory for the success of the procedure are: 1) Vision blue staining of the anterior capsule to visualize and to manipulate it 2) Capsulorexis without breaking the flap 3) Flattening and positioning of the flap in the superior part of anterior chamber ,with the help of manipolator and viscoelastic substance. 4) Procedure of phacoemulsification is performed under the anterior capsule which is an efficient barrier for protecting the endothelium . If the the flap decenters during hydrodissection or phacoemulsification , it's repositioned by viscoelastic 5) Aspiration of the flap in the final part of phacoemulsification.


No intraoperative complications . The post operative managment was not complicated , and the endothelial counting shows an efficient protection.


E.P.A.C technique minimizes the risk of iatrogenic damages. The anterior capsule protects endothelium during phacoemulsification ,in phase 1 where ultrasounds are more powerful, and in phase 2 where the flow rate is elevated and there is turbolence in anterior chamber ,reducing the risk of post surgical corneal decompensation

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