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Simplified Phacoemulsification

Συγγραφείς: Navneet Toshniwal
ISBN: 9789350904428

Ημ. Έκδοσης






Κύριος Συγγραφέας

30,00(Περιλαμβάνεται ΦΠΑ 6%)

Διαθεσιμότητα: 23-28 ημέρες


Cataracts are a very common condition whereby the lens of the eye becomes cloudy causing blurred vision. Over time, a cataract can get worse, eventually leading to blindness if untreated. Cataracts are the most common cause of blindness worldwide. Phacoemulsification surgery is the most widely used method for cataract management.

Simplified Phacoemulsification is a step by step guide to the complete technique of phacoemulsification.

Beginning with an introduction to the anatomy and development of the lens, patient selection and the phacoemulsification machine used in the procedure, the following chapters describe the complete process from anaesthesia, suturing and incision, through the different basic and technical aspects of the technique. The final section examines instruments used for phaco surgery.

Written in an easy to read, short note format, this comprehensive manual includes more than 280 full colour images and figures to enhance learning.

Key points

  • Step by step guide to phacoemulsification
  • Covers complete process from basic anatomy and development, to anaesthesia and suturing, and technical aspects of the procedure
  • Easy to read, short note format
  • Includes more than 280 full colour images, figures and illustrations


1. Anatomy and Development of Lens 1
ƒ Lens Capsule 1
ƒ Lens Epithelium 2
ƒ Lens Fibers 2
ƒ Lens Proteins 3
ƒ Lens Metabolism 3
ƒ Development of Lens 3
2. Selection of Patient 6
ƒ History 6
ƒ General Examination 6
ƒ Systemic Examination 7
ƒ Other Factors 8
ƒ Local Examination 8
ƒ Slit-Lamp Photograph of Cataracts—Selection and Analysis 12
3. Phacoemulsification Machine 21
ƒ Parts of Phaco Machine 21
ƒ Preperation or Tuning of the Phaco Machine 31
ƒ Cleaning of Phaco Machine 31
ƒ Following are the Important Terms
Concerned with the Phaco Machine 31
ƒ Irrigation and Aspiration 35
4. Anesthesia 36
ƒ Types of Anesthesia 36
ƒ Local or Regional Anesthesia 36
ƒ Topical Anesthesia 37
ƒ General Anesthesia 37
ƒ Regional Anesthesia 38
ƒ Topical Anesthesia 38
ƒ General Anesthesia 39
5. Bridle Sutures 40
ƒ Superior Rectus Bridle Suture 40
ƒ Inferior Rectus Bridle Suture 41
ƒ Complications 42
6. Incision 43
ƒ IncisionS Used in Surgery 43
ƒ Principle of Incision 44

ƒ Construction of Wound 44
ƒ Procedure 46
ƒ Advantages and Disadvantages of Different
Types of Main Port Incision 54
ƒ Correlation of Phaco Fluidics with Incision 56
ƒ Correlation of Incision with Iris Movement 56
7. Capsulorhexis 58
ƒ Anatomical Consideration 58
ƒ Prerequisites 59
ƒ Physics of Capsulorhexis 59
ƒ Instruments 60
ƒ Solutions 63
ƒ Technique of Capsulorhexis 64
ƒ Zones of the Capsulorhexis 67
ƒ Speed of the Capsulorexis 69
ƒ Viscoelatstics in Capsulorhexis 69
ƒ Anatomical Variations 71
ƒ How to Practice Capsulorhexis 72
ƒ Running Away of the Capsulorhexis 72
8. Hydro Procedures 80
ƒ Procedure 81
ƒ Complication 83
ƒ Advantages 84
ƒ Disadvantages 84
9. Trench of Nucleus 88
ƒ Definition 87
ƒ Prerequisite 88
ƒ Technique 88
ƒ What is the Ideal Trench 90
ƒ Variations of Trench in Different Types of Cataract 95
ƒ Complications of Trench 97
ƒ Factors Needed to Master this Important Step of Phaco 97
ƒ Variations in Design of Trench During Learning
Phase and Trench Related to Different Mind Set 97
10. Division of Nucleus 109
ƒ Prerequisite 109
ƒ Principle 109
ƒ Techniques 111
ƒ Akahoshi Prechopper 115
ƒ Toshniwal Prechopper 115
ƒ Procedure 116
ƒ Important Tips Related to Division 117

ƒ Different Happenings During Division 118
ƒ Correlation of Trench with Division 119
ƒ Division in Soft Cataract 120
ƒ Complications of Division 121
ƒ Difficulties During Division 121
11. Hold and Chop of Nucleus 130
ƒ Instruments Needed 130
ƒ Principle of Hold 131
ƒ Role of Vacuum and Aspiration Flow Rate 132
ƒ Role of Energy 132
ƒ Positions of Foot Pedal 132
ƒ Functions of Foot Pedals 132
ƒ Principle of Chop 133
ƒ Types of Chopping 133
ƒ Parameter of Hold 134
ƒ Prerequistie for Hold and Chop 135
ƒ Rotation of Nucleus 135
ƒ Principle of Rotation 135
ƒ Correlation of Hold and Chop with Foot Pedal 138
ƒ Variations for Hold 141
ƒ Complications During Hold and Chop 142
ƒ Difficulties During Hold and Chop 142
ƒ Difficult Situations for Hold and Chop 142
ƒ Role of Chopper 142
ƒ Misuse of Chopper 143
ƒ Placement of Chopper 143
ƒ Types of Choppers 143
ƒ Complications due to the Chopper 144
ƒ Speed of the Chopper 144
12. Removal of Small Pieces of Nucleus 154
ƒ Instruments 154
ƒ Principle 155
ƒ Ideal Site to Remove Small Pieces 155
ƒ Parameters 156
ƒ Correlation of Foot Pedal with Parameter is Most Important 156
ƒ Role of Energy, Vacuum and Flow Rate 157
ƒ Phaco Tip 160
ƒ Role of Chopper 163
ƒ Misuse of Chopper 166
ƒ Viscoelastics and Viscocannula 166
ƒ Complication 167

13. Irrigation and Aspiration 178
ƒ Types 178
ƒ Coaxial Irrigation-Aspiration 178
ƒ Cap-Vac Mode 184
ƒ Bimanual Irrigation-Aspiration 185
ƒ Manual Irrigation and Aspiration 188
ƒ Indication in Phaco 189
ƒ Complication 189
14. Intraocular Lens—Basic and Technical Aspects 199
ƒ Material Use 199
ƒ Types of Lenses 199
ƒ Different Classification 200
ƒ Other Classification 200
ƒ Foldable Lens 201
ƒ Poly Methyl Methacrylate Lens 203
ƒ Finishing Steps of Phaco Surgery after Putting IOL 203
15. No Hydro in Phaco 205
ƒ History 205
ƒ Definition 206
ƒ Evolution of Phaco Surgery in Authors Practice Related to
Hydroprocedures 207
16. Instruments for Phaco Surgery 209
Index 219