1- Ant Chamber 2- Iris Plane 3- Post chamber 4- Supracapsular
5) Endolenticular
Slide 3
1- Ant Chamber 2- Iris Plane 3- Post chamber 4- Supracapsular
5) Endolenticular
Slide 4
Anterior Chamber 1- Post capsule damage is minimized 2- Risk of
corneal endothelium is more 3- Used if the posterior capsule has
ruptured or patient has high myopia
Slide 5
Iris Plane 1- Risk of damage to corneal endothelium and post
capsule is reduced. 2- Good for small pupils. 3- Often desirable
for beginners.
Slide 6
Slide 7
Posterior Chamber 1- Preferred location for phaco 2- More risk
for post capsule
Slide 8
Supracapsular Phaco (1997) Malony 1- More recent innovation 2-
Reduces the stress on the zonules during nucleus manipulation. 3-
Can be used in small-pupil cases. 4- Needs a large capsulorrhexis.
5- Nucleus is flipped with hydrodisection.
Slide 9
Endolenticular 1- Uses a very small opening in ant capsule 2-
Has maximum endothelial protection 3- Future possibility of
injecting synthetic lens material into an almost intact capsular
bag 4- Increased risk of posterior capsule rupture during both
hydrodissection and emulsification
Slide 10
Slide 11
Types of Phacos 1 ) whole nucleus removal central nuclear
sculpting and creation of a D-shaped nuclear bowl
Slide 12
1) Whole-nucleus removal The nucleus can be emulsified as a
whole 1- In either the iris plane or the post chamber 2- Needs
large capsular opening
Slide 13
2) Chip and Flip Techniques a) Removal of the central core of
the nucleus by sculpting and creating a nuclear bowl b) Entire rim
of inner nuclear bowl is removed and the posterior nuclear chip
remains c) Soft epinuclear bowl acting as a cushion and it should
be tumbled or flipped and aspirated
Slide 14
Slide 15
3) Phaco Fracture Technique Gimbel developed a useful technique
for hard nuclei a) 4 quadrant nucleo fractures technique. b) Linear
groove is created perpendicular to the first
Slide 16
Nucleus-splitting techniques 1- Hydrodelination separates hard
endonuclus 2- nucleus is divided into pieces before removal from
the capsular bag