MICRO-BIAXIAL PRECHOP AT THE IRIS PLANE

Arturo Pèrez-Arteaga M.D.Medical Director, Centro Oftalmològico Tlalnepantla, Mèxico.Poster Presentation, ASCRS meeting.Boston, 2010.

FINANTIAL DISCLOSURE

I HAVE NO FINANTIAL INTERESTS OR RELATIONSHIPS TO DISCLOSE

PURPOSETo demonstrate the

safety and efficacy of performing pre-chop at the iris plane in a bi-axial mode.

ADVANTAGES OF PRECHOPPING Decreases the Phaco

Time and Power. Uses mechanical forces

instead of ultrasound. Facilitates

Phacoemulsification. Improves followability. Decreases the force

applied to capsular tissues.

Decreases total surgical time.

COMPARISON OF TWO FRAGMENTATION SITES

Inside the Capsular Bag Outside the Capsular Bag

To work at the iris plane decreases the Capsular and Zonular Trauma

BI-AXIAL PRECHOPPING WITH TWO 25G CANNULAS (BAPC25G)

It uses only two viscoelastic cannulas to fragmentate the nucleus.

The fragmentation is outside the capsular bag with the “Lens Salute Technique”. It uses the Iris Plane.

It uses a Bi-Axial approach with two cannulas “face to face”.

SUR

GIC

AL TEC

HN

IQU

E. BIA

XIA

L PR

ECH

OP 25 G

1. Wide Capsulorrhexis.

2. Vigorous Hydrosurgery.

3. Nucleus placed in “Lens Salute Position”.

4. Intraocular tissues protected with viscoelastic.

5. Cannulas introduced at 120 to 180 degrees.

6. Force applied between two cannulas, to fracture the nucleus at the iris plane.

7. Multiple fragmentations.

8. Phaco as usual.

COMPARISON STUDY BETWEEN TECHNIQUES. 200 EYES, ONE SURGEON, 8 MONHTS, INTRAOPERATIVE AND POSTOPERATIVE RECORDS.

Total surgical time Corneal edema Phaco power & time Time of visual

recovery. Final visual

outcome SIX CASES OF

CAPSULAR DAMAGE.

Total surgical time Corneal edema Phaco power & time Time of visual

recovery Final visual

outcome TWO CASE OF

CAPSULAR DAMAGE

Prechopp at the Capsular Bag. Forceps & Choppers.Comparative Group, 100 e.Retrospective review.

Bi-Axial Prechop.Iris plane. Two 25 G Cannulas.Experimental Group. 100e. Prospective data.

CONCLUSION BIAXIAL PRECHOP WITH 25 G CANNULAS

We were not able to determine if the moment of capsular damage was during the prechop maneuver.

We just did a comparison of capsular damage while performing both techniques

CONCLUSION BIAXIAL PRECHOP WITH 25 G CANNULAS

It is a safe and effective method to produce mechanical fragmentation.

It decreases the forces applied to the capsular bag and the zonula.

It is cost-effective because it avoids expensive instrumentation

CONCLUSION BIAXIAL PRECHOP WITH 25 G CANNULAS

It can be useful as a method of nuclear fragmentation for many other lens extraction techniques (Bi-Axial Phaco, Co-Axial Phaco, Manual Phacofragmentation techniques)

It is not exclusive of Bi-Axial Techniques.

THANK YOU VERY MUCH