Dr shivani Phacoemulsification steps 3.pptx

This presentation describes the steps used in phacoemulsification in detail with videos

1. PHACOEMULSIFICATION 3 Dr Shivani Kinha Junior Resident Department of Ophthalmology

2. APPLIED ANATOMY

3. Nucleotomy Techniques Phases Of Phacoemulsification 1.Sculpt 2. Chop 3. QUADRANT REMOVAL Low vacuum Low aspiration High vacuum High Aspiration High vacuum High ultrasound power

4. Which technique to choose?? No single best technique Surgeon preference Grade of cataract Capsular status Zonular status Pupil size Corneal endothelium

5. Nucleotomy Techniques Divide and conquer Phaco -Chop Divide and conquer Crater Divide and conquer Non-dominant hand is not critical Increased exposure to ultrasound energy Phaco-Chop Stop & chop Less exposure to ultrasound energy Non dominant hand is critical for success

6. Divide and Conquer- step by step

7. Nucleus Cracking

8. Good for beginners Phaco settings Low vacuum & low aspiration High phaco power Good trench creation is essential

9. Tips & tricks for divide & conquer Good trench Length- upto CCC Depth- 1 tip deep Width- 2 tip wide Good fundall glow Good Crack Instrument deep in groove Adequate traction

10. Direct chop

11. Holding the Nucleus

12. Power settings High vacumm High aspiration Phaco power – grade of cataract

13. How to chop

14. INABILITY TO CHOP

15. Stop & Chop

16. Power settings

17. Phaco aspiration Aspiration from central safe zone The first piece is the most difficult Ideal- remove smallest & most free fragment Plane Posterior Iris plane Anterior

18. Phaco aspiration

19. Power settings

20. Posterior Capsular Rent

21. Signs of rupture

22. THANK YOU