Determination of intralenticular pressure in patients with intumescent cataract

Fabrikantov, O.L.; Nikolashin, S.I.; Shutova, S.V.; Pirogova, E.S.

doi:10.17116/oftalma2018134342

Cited by 2 publications

(6 citation statements)

References 18 publications

(2 reference statements)

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“…The use of dispersive OVDs to maintain AC creates a pressure gradient between the lens and the AC with a higher pressure inside the lens [3]. This pressure gradient is created with the aid of gentle pressure on the lower lip of the main incision with a fine spatula.…”

Section: Discussionmentioning

confidence: 99%

“…However, this initial central decompression may still be inadequate and carries the risk of more unsafe maneuvers in unsteady pressure forces between the AC and ILP. The downward pressure exerted by cohesive OVDs described by many may be dangerous [3,8]. The force in the AC and intralenticular force are two opposing high forces once the elastic capsule is punctured by the cystotome, and because the nature of the capsule is elastic, the capsule will obey the law of power, so if the ILP is higher, the Argentinian flag radial tear will occur [14].…”

Section: Discussionmentioning

confidence: 99%

“…These include selecting a medical school and residency program, choosing between academic and private practice, whether to pursue fellowship training and/or additional advanced degrees such as a Master of Public Health (MPH), Master of Business Administration (MBA), or Doctor of Philosophy (PhD). These options can be instrumental in facilitating a fruitful academic career [1][2][3][4]. Previous studies have described the characteristics of American ophthalmology residency program directors [1], department chairs [2], and clinician-scientists receiving National Institute of Health (NIH) grants [3].…”

Section: Introductionmentioning

confidence: 99%

“…These options can be instrumental in facilitating a fruitful academic career [1][2][3][4]. Previous studies have described the characteristics of American ophthalmology residency program directors [1], department chairs [2], and clinician-scientists receiving National Institute of Health (NIH) grants [3]. Gershoni et al investigated the impact of subspecialty choice on research productivity,…”

Section: Introductionmentioning

confidence: 99%

“…In these mature cataracts, the capsule tends to be thin, and the absence of red reflex results in difficult visualization of the capsule edge during capsulorhexis. There is also a tendency for the anterior capsule tear to extend toward the periphery after the swollen lens is punctured, with spillage of liquefied cortical material and sudden loss of capsule visibility [3][4][5]. Due to the high intralenticular pressure (ILP) [6,7], capsulorhexis tears tend to extend to the periphery, forming a radial tear that produces the so-called Argentinian flag sign [2], which can be observed when the capsule is stained with trypan blue.…”

Section: Introductionmentioning

confidence: 99%

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Modified capsulorhexis for fluid-filled mature cataracts

Ghoneim¹

2021

Med Hypothesis Discov Innov Ophthalmol

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Background: The aim of this study was to develop a modified capsulorhexis technique featuring a new maneuver for the removal of subcortical fluid in fluid-filled mature cataracts to avoid high intralenticular pressure. Methods: This prospective interventional study included 33 eyes with mature cataracts and evidence of subcapsular fluid spaces by slit lamp examination. For each patient, 20% mannitol was administered intravenously according to the bodyweight 1 h preoperatively. Under peribulbar anesthesia, a 2.2-mm main incision was made, and the anterior chamber was filled with a dispersive ophthalmic viscosurgical device. Using a bent-tip cystotome, a 2-mm curved incision was made in the center of the anterior capsule, which released subcortical fluid and was drained through compression of the posterior lip of the main incision using a spatula. Then, fine gentle milking in all quadrants around the puncture on the anterior lens capsule from the periphery toward the site of puncture using the blunt-edged spatula further assists drainage of subcortical fluid and breaks fine septa inside the lens to remove fluid from intralenticular fluid pocket collections. Results: The study included 15 (45.5%) men and 18 (54.5%) women with a mean ± standard deviation (SD) of age of 63.2 ± 5.33 and 64.4 ± 6.21 years, respectively. The modified capsulorhexis technique was performed for 33 intumescent cataracts. Capsulorhexis was completed in all cases; capsulorhexis was easy in 31 (94%) eyes and difficult in 2 (6%) eyes. In the two difficult cases, radial extension occurred in one eye, and it was retrieved using the Little technique; the other case with radial tear was completed successfully using a retinal micro scissor from the other edge of the capsulorhexis until reaching an oval, continuous capsulorhexis. Conclusions: This modified capsulorhexis technique with compression on the posterior lip of the main incision and capsule milking allowed for a safe, continuous curvilinear capsulorhexis. Further comparative studies are necessary to confirm our preliminary results. How to cite this article: Ghoneim EM. Modified capsulorhexis for fluid-filled mature cataracts. Med Hypothesis Discov Innov Ophthalmol. 2021 Summer; 10(2): 17-24. https://doi.org/10.51329/mehdioptometry1422

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Section: Discussionmentioning

confidence: 99%