Phacoemulsification of a nucleus in the vitreous cavity

Abstract

Loss of the crystalline lens into the vitreous cavity can lead to corneal damage and expulsive hemorrhage. In this technique, the lens is released from adhesions by vitrectomy and then extracted from the vitreous cavity by phacoemulsification using a special tip. No protective liquids are used to cover the retina. This technique was successful in 44 patients.

Nitinol basket‐assisted pars plana vitrectomy for retained lens material removal

“…Also, the possibility of micrometallic fragments release from the tip or the cannula cannot be excluded when high‐frequency vibrating metallic parts touch each other. Other techniques have been proposed to try to minimize the use of 20‐gauge frag and reduce the intra‐ and postoperative complication rate (Röver ; Barthelmes et al. ; Erakun et al.…”

“…The surgical approach for management of intravitreal lens material during cataract surgery has evolved significantly as Verhoeff () suggested irrigation of vitreous with normal saline solution to retrieve the lens. Röver () first reported the use of a special ultrasound tip for the phacoemulsification in the vitreous cavity. Phacofragmatome helps to emulsify the nucleus in the vitreous cavity itself but increases the risk of retinal tear and retinal detachment (Barthelmes et al.…”

Phacofragmentation with perfluorocarbon liquid and anterior chamber or scleral-fixated intraocular lens implantation for the management of luxated crystalline lenses

“…[1][2][3] The use of perfluorocarbon liquid (PFCL) allows safer manipulations in the vitreous cavity 7-11 and ultrasound (US) phacofragmentation allows removing the crystalline lens in a closed system even in cases of a hard nucleus. [10][11][12][13][14][15] Intraocular lens (IOL) implantation is needed to achieve good visual rehabilitation. Therefore, wound healing and postoperative astigmatism depend on the type of IOL implantation.…”

“…We confirm observations of other authors that no excessive heat causing any scleral burns is generated at the fragmatome port. 10,11,[13][14][15] The effective phaco time was between 19 and 50 seconds for 1C and 2C nuclei; between 50 and 100 seconds for 3C nuclei; and in some cases of hard cataracts (4C), it was between 100 and 130 seconds. These data are similar to results published by Imai et al 13 In all cases, IOLs were implanted simultaneously.…”

Clinical outcomes of sleeveless phacotip assisted levitation of dropped nucleus

“…But in cases of entire nucleus drop or dense fragments, the issue needs to be addressed adequately. Röver first reported the use of a special ultrasound tip for phacoemulsification in the vitreous cavity 2. Phacofragmatome helps to emulsify the nucleus in the vitreous cavity itself but increases the risk of retinal tear and retinal detachment 3.…”