RESUMO
[Methods for reducing traumatism of the posterior corneal epithelium during ultrasound phacoemulsification]
Assuntos
Doenças da Córnea/prevenção & controle , Epitélio Corneano/lesões , Complicações Intraoperatórias/prevenção & controle , Facoemulsificação/efeitos adversos , Ultrassom/efeitos adversos , Doenças da Córnea/epidemiologia , Doenças da Córnea/etiologia , Humanos , Incidência , Complicações Intraoperatórias/epidemiologia , Complicações Intraoperatórias/etiologia , Facoemulsificação/métodosRESUMO
Phacoemulsification is the most sparing technique of cataract removal in patients with open-angle glaucoma. The retention of intraocular fluid should be determined to choose a pathogenetically oriented antiglaucoma operation for uncompensated open-angle glaucoma (OAG). The study of the Schlemm's canal retrograde blood filling phenomenon may be a technique of the most informative value. The phenomenon was studied on 102 eyes (in 82 cases of glaucoma) during phacoemulsification, which indicated the high effectiveness and safety of the use of this intraoperative method. Its advantage is that manipulations are easy-to-use and accessible. This method is of particular value in treating patients with cataract concurrent with OAG, who are to undergo phacoemulsification with a one-stage pathogenetically oriented antiglaucoma operation.
Assuntos
Catarata/complicações , Glaucoma de Ângulo Aberto/complicações , Facoemulsificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Humor Aquoso , Catarata/diagnóstico , Feminino , Glaucoma de Ângulo Aberto/diagnóstico , Humanos , Pressão Intraocular , Implante de Lente Intraocular , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Acuidade VisualRESUMO
Clinical estimation of different modifications of phacoemulsification revealed the formation of the second tunnel in the nucleus for its division into quadrants in "four-quadrant phaco" increases the required duration of ultrasonography (US) and irrigation, which causes greater endothelial losses associated with the use of nuclear breakdown by means of a chopper tunnel. When the authors used their own methods of "extracapsular half-nuclei" fragmentation, endothelial losses are rather greater than those with the similar method "stop & "chop", which is associated with closer disposition of the US tip to the posterior corneal surface. At the same time nuclear breakdown by means a chapper in the capsular sac by the "stop & chop" method causes dilation of Zinn's ligaments, fraught by their rupture, particularly if latent derangement or defects of the zonular apparatus, and increases the risk of damage to the posterior capsule by the chopper.
