Biaxial Phaco for Difficult and Challenging Cases
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Phacoemulsification in the Presence of Very Shallow Anterior Chambers
In cases of shallow anterior chambers, Dr. Fine suggests performing a 25 G transcleral pars plana vitrectomy prior to cataract removal. The smaller biaxial phaco instruments are particularly beneficial in these circumstances.
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Biaxial Phaco for Difficult and Challenging Cases
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Phacoemulsification in the Presence of Very Shallo…
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High Myopia
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Bimanual posterior polar cataract
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Switching phaco hands
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Posterior subluxed cataract
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Mature cataract with zonular dialysis during phaco
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A punctured posterior capsule
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Pseudoexfoliation post glaucoma in filtration surg…
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Rock Hard Nuclei
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Rock Hard Nucleus (Case 2)
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Micro cornea and iris coloboma
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Phaco post malignant melanoma excision
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Hydroexpression of the lens in IFIS
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The use of Healon 5 with bimanual microincision ph…
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Every small pupil must be viewed as a potential IF…
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Iris Bombe
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Bimanual microincision RLE
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Intraocular cautery
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Late recentering of IOL and insertion of CTR
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Late reopening of fibrosed capsule
Comments (3)
Could this technique be associated with an increased incidence of Retinal Detachment? How long was the follow up for these patients?
In two cases of acute angle closure glaucoma I used a quite similar technique for removing the thick lens and placing an IOL and restoring the anterior segment architecture. Vitrectomy at that time was performed with a 'normal anterior' vitrectoom and the irrigation closed.
Beautiful technique - as you stated, judging the length and amoung of 25gauge PPV or deepening is critical. I do this by keeping an anterior chamber maintener or an irrigating chopper/manipulator on during the PPV, and titrating the PPV to the increasing depth of the chamber.