Table of Contents - WOC 2012

VI-CAT-48
A NEW PHACO NEEDLE
Joseph Mathew (1)
1. Ozanam Eye Centre
Objective To present a New Design Phaco Needle Summary A new design for
the tip of the Phaco needle is presented. Unlike the current Phaco Needle in
common use today which has a single tip, the new needle has two tips. This
theoretically doubles the phaco tips. As can be seen from the photos and the
diagrams, the sickle shaped sharp knife edges between the tips also aid in
emulsification. The aspiration port of the new tip gets closer to the cataract
when two tips are made, as compared to the single tip needle. There fore,
aspiration and holding of the lens bits is better.
VI-CAT-49
INTERACTIVE CATARACT SURGERY ANIMATION -THE NEW FACE
OF PATIENT INFORMATION
Waqar Salman (1) , Park Jonathan (1) , Modi Neil (1) , Kersey Tom (1) , Sleep Tamsin
(1)
1. Department of Ophthalmology, Torbay General Hospital
OBJECTIVE/PURPOSE: To showcase an interactive cataract surgery
animation developed by our team aimed at enhancing patient knowledge and
awareness during the procedure.
Summary Of Content: The video is a running version of a unique interactive
animation available at www.myeyesurgery.org.uk. It takes the user on an
interactive journey through the steps of a cataract operation starting from
the preoperative workup, proceeding through the anaesthetic provision and
finally allowing the user to undertake steps in the actual operation itself. The
information in the animation is supplemented by post operative instructions and
details regarding complication rates available on the website. It is envisaged
that it will not only be of benefit to patients but also to medical students and
new ophthalmic trainees seeking to familiarise themselves with the steps in a
cataract operation before entering live theatres.
VI-CAT-50
Phaco in Shallow Waters - Challenges and Opportunities!
Pal Dipanjan (1) , Sengupta Jayangshu (1)
1. Priyamvada Birla Aravind Eye Hospital
Purpose: To highlight the surgical pearls in overcoming challenges of
Phacoemulsification in eyes with narrow angles.
Summary Of Content: Cataract surgery in patients with chronic angle closure
poses myriads of challenges. Peripheral anterior synechia, rigid pupil and
other inflammatory sequel along with anteriorly displaced lens-iris diaphragm
presents surgeons with difficulties in anterior chamber entry,rhexis and
manipulations and may be responsible for damage to adjacent tissues. This
video highlights the surgical techniques taking care of the intraoperative
difficulties, use of correct instruments and devices while manipulating hard
cataracts, small pupil and shallow chamber depth together or in isolation. It
also demonstrates technique of internal bleb revision during cataract surgery
in presence of a preexisting failed filter.
VI-CAT-51
Capsular support segment - demonstration of a new design on
cadaver eye.
Gupta Satish (1)
1. Venu Eye Institute and Research Centre
Objective/Purpose: To highlight the advantages of an innovative capsular
support segment over the currently available Capsular Tension (CT) segment
(Ahmed) by demonstrating the behavior of the two in cadaver eyes. Summary
of the contents: An eccentric corneo secleral button was removed from a
cadaver eye using an 11mm trephine so as to expose the ciliary body on one
side. Iris was stripped off to expose the lens and the zonules. A dye enhanced
continuous curvelinear capsularhexis was done. Three clock hours of zonuler
dehiscence was created. Lens matter was removed from the capsular bag by
hydroexpression. Ahmed CT segment was sutured to sclera to support the
capsular bag in one eye, while the new design capsular support segment was
placed in the other. The advantage in the position of the fixing arm in the new
design is clearly seen in relation to the ciliary sulcus. In addition, the titration of
the fixation suture is well demonstrated in the video.
WOC2012 Abstract Book
VI-CAT-52
An innovative Phaco Surgical Procedure on a Hyper Mature Cataract
Amaratunge Shamintha
1. Wijaya Kumaratunge Memorial Hospital
Objective/Purpose: An innovative Phaco Surgical Procedure on a Hyper
Mature Cataract . Phaco Surgery on a Hyper Mature Cataract is a challenging
procedure. Because; -Increased Intralenticular Pressure -
Difficulty in visualization of the capsule -Weak Zonules and thin capsul-
Absence of Cortical support during Phacoemulsification. This video shows;
1. Use of Trypan blue to stain the capsule 2. Use of Viscoelastic (HPMC) to
counteract Intralenticular pressure. 3. Creation of a small rhexis at the centre to
prevent extension to the periphery. 4. Aspiration of cortical matter to reduce the
intralenticular pressure 5. Creation of the second rhexis for nuclear handling
6. Dislocation of the nucleus into the anterior chamber with the help of Phaco
tip with high vacuum. 7. Injection of Viscoelastic behind and in front of the
nucleus to float it in the anterior chamber without touching the cornea which
creates a path to insert the IOL. 8. Insertion of IOL into the bag 9. Pushing the
nucleus backward with the chopper 10. Phacoemulsification of the nucleus in
the anterior chamber on the IOL. 11. Aspiration of remaining lens matter and
Viscoelastic 12. Wound Hydration
VI-CAT-53
Safe Phacoemulsification in a Small Pupil: Malyugin›s Ring
Shobaki Ahmad (1)
1. King Hussein Medical Center, Royal Medical Services
PURPOSE: To assess the safety of using Malyugin›s ring in small pupil
phacoemulsification.
Summary Of Content: Small pupil cataract surgery is challenging for phaco
surgeon particularly if it is accompanied with shallow A/C, pre-existing filtering
blebs, hypotony, and pseudoexfoliation.A wide variety of techniques have
been described to surgically enlarge the pupil. One approach to multiple
sphincterotomies with peripheral iridectomy. Other surgical options include
mechanical dilatation of the pupil using iris retraction devices with the
disadvantage of being rigid and difficult to insert, remove and manipulate. Also
another technique is flexible iris hooks that may result in postoperative atonic
pupils. In 2001, Boris Malyugin used a device made of 5-0 prolene a square
shaped implant with four circular loops and depends on the scroll principle
to catch the papillary margin with gentle and less trauma to the iris margin
with controlled stretching of the pupil. In this presentation, I will show different
videos for the use of Malyugin ring at King Hussein Medical Center in patients
with small pupil due to different causes such as pseudoexfoliation, posterior
synechiae, tonic pupils, trauma, or previous intraocular surgery.
VI-CAT-54
Low Vacuum Stop & Chop Phacoemulsification
Punjabi Mahesh (1) , Mahesh Sandhya (1) , Punjabi Ankit (1) , Ghatak Mrinmayee
(1)
1. Kota Eye Hospital and Research Foundation
Objective/Purpose: To demonstrate the use of a modified Stop & Chop
Phacoemulsification technique using low vacuum settings in various cataracts.
Summary of the content: Use of Low vacuum settings achieve similar results
as with routine high vacuum. It provides superior anterior chamber stability,
reduces chances of posterior capsular rent and maximizes the surgeon›s
comfort.
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