Modified parameters of phacoemulsification in high myopia

ABSTRACT

Phacoemulsification is more challenging in high myopia than in other eyes because the globe is superelongated and the sclera is thinned out. This study aimed at overcoming the technical difficulties encountered in high myopic eyes by modifying the parameters of phacoemulsification. This study included 30 eyes of 20 patients, 13 males and 7 females [ranging in age from 44 to 62 years]. Their axial lengths ranged from 28 to 32 mm., they had posterior cortical and nuclear cataract [nuclear hardening were grade II and grade III]. The incision was clear corneal tunnel starting posteriorly limbal, the technique of choice was divide and conquer phacoemulsification keeping the bottle height constant at 70cm. in all phacoemulsification steps phaco I, phaco II and irrigation- aspiration [I / A]. Phacoemulsification of high myopic eyes with standard phaco parameters is associated with many difficulties, like fluctuation of anterior and posterior chambers and impairement of good visualization, also there is increased risk of posterior capsule rupture and zonular dialysis. Our results on using the new phaco parameters were very promising, there was no fluctuation of anterior and posterior chambers encountered, the visualization of the nucleus during emulsification and the posterior capsule during I / A was very good in all cases and no cases of posterior capsule rupture or zonular dialysis were recorded. In conclusion phacoemulsification of high myopic eyes with modified parameters offered us better visualization, reduction of the load on the lens ligaments apparatus and facilitated the manipulations made oh the lens nucleus and cortical matter cleaning out