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Lanjutan (selesai) – INTRAOCULAR LENS CALCULATIONS

III. FORMULAS Lens power calculation formulas have evolved over the past 30 years, since the first theoretical formula for iris-supported lenses was published by Fyodorov and Kolonko in 1967. A. First Generation Initial formulas were based largely on axial length, but with the availability of posterior chamber implants, consideration had to be given to the…

INTRAOCULAR LENS CALCULATIONS

I. INTRODUCTION Choosing the appropriate intraocular lens (IOL) power is a major determinant of patient satisfaction with cataract surgery. The 3 main factors to consider include taking accurate measurements (biometry), selecting appropriate calculations (formulas), and assessing the patient’s needs and expectations to determine the postoperative refractive target (clinical considerations). II. BIOMETRY At minimum, 2 measurements…

Lanjutan (selesai) – IRRIGATION AND ASPIRATION

IV. TECHNIQUE The I/A hand piece is classically used for cortex removal. However, there are a number of other circumstances in which the I/A hand piece is used in cataract surgery, and the techniques of I/A can be approached in a stepwise fashion. A. Wounds and Hydrodissection Like most steps in successful cataract surgery, efficient…

IRRIGATION AND ASPIRATION

I. INTRODUCTION Removal of residual cortical material following phacoemulsification can at times be challenging and can lead to posterior capsular rupture. Understanding the principles and techniques of irrigation and aspiration (I/A) will enable the surgeon to use a structured approach and allow for safe and efficient evacuation of residual cortex. II. CORTEX ANATOMY During cataract surgery,…

Lanjutan (Selesai) – PHACO CHOP TECHNIQUES

VI. PURE CHOPPING TECHNIQUES There are 5 important advantages to phaco chop: 1. Reduction in energy delivery 2. Reduction in stress on the zonules and capsular bag 3. Supracapsular emulsification 4. Decreased reliance on the red reflex 5. Greater reliance on the chopper than the phaco tip A. Reduction in Energy Delivery Pure chopping techniques eliminate lens…

PHACO CHOP TECHNIQUES

I. INTRODUCTION All chopping techniques rely on the principle of lens “disassembly,” in which the firm nucleus is divided into smaller maneuverable pieces. As a result the 10-mm wide nucleus can be removed through a 5-mm diameter capsulorrhexis, and the majority of the nucleus is emulsified near the center of the pupil at a safe distance…

Lanjutan (selesai), PHACOEMULSIFICATION: NONCHOPPING TECHNIQUES

IV. GROOVING TECHNIQUE In creating the initial lens sulcus, the depth of the groove is of the utmost importance because this will allow the surgeon to ideally position the phaco tip and second instrument to crack the base of the lens. In general, the groove does not need to extend into the periphery, maintaining the peripheral…

PHACOEMULSIFICATION NONCHOPPING TECHNIQUES

I. INTRODUCTION Nonchopping phacoemulsification techniques, also known as nuclear- fracturing techniques, have facilitated cataract surgery immensely, allowing for safer and more efficient means of nucleus removal. The fundamental principle underlying all nuclear-fracturing techniques is the creation of “breaks” to divide the lens into smaller fragments for controlled removal through a small incision. Gimbel was the…

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