Technical difficulties and possibilities in surgical prophylaxis of intraoperative complications during the phacoemulsification of the age-related cataract in eyes with a short axial length

Abstract

ABSTRACT Purpose. To study initially unfavorable technical features of intraoperative phacoemulsification (PE) difficulties of the age-related ataract in eyes with a short axial length and a search of possibilities to overcome them. Material and methods. Nuances of PE performance of the agerelated cataract were analyzed in 89 eyes with a short axial length as well as their long-term results. The nuclear form of cataract, the increased density of a lens nucleus prevailed. The PE technique: technology of small cuts, implantation of the flexible IOL, the torsion mode of ultrasound. There was carried out a detailed evaluation of technical features of PE performance. The follow-up was 3 years. Results. There were revealed following adverse features of PE performance: an increased risk of insertion of the iris root because of a shallow anterior chamber; dense and large nuclei of lenses, an increased frequency of capsular bag incompetence, a frequent combination with a deep eyeball location in the orbit and prominent superciliary arches. Conclusion. The techniques used by us to overcome the increased risk of intraoperative complications included: a blepharostat application with a built-in aspiration system, the torsion mode of ultrasound (OZIL) with an increase of vacuum up to 600mmHg and an aspiration irrigation flow up to 42-50ml/min, an additional sealing of the cut with the DisCoVisc viscoelastic, a minimization of liquid volume injected into the sub-capsular space, an application of the technique for an incomplete cracking of nucleus (by 3/4 of its depth).

Keywords

• short axial length of an eye
• phacoemulsification
• features of surgery