У нас вы можете посмотреть бесплатно Pediatric Cataract Surgery with Posterior Capsule Defect .Dr Suresh K Pandey mpg или скачать в максимальном доступном качестве, видео которое было загружено на ютуб. Для загрузки выберите вариант из формы ниже:
Если кнопки скачивания не
загрузились
НАЖМИТЕ ЗДЕСЬ или обновите страницу
Если возникают проблемы со скачиванием видео, пожалуйста напишите в поддержку по адресу внизу
страницы.
Спасибо за использование сервиса ClipSaver.ru
In this video, Dr Suresh K Pandey and Dr Vidushi Sharma, Eye Surgeons of SuVi Eye Institute & Research Center, Kota, Rajasthan,India (www.suvieye.com) share pearls for performing pediatric cataract surgery and Implantation of AMO Tecnis 1 aspheric IOL in presence of posterior capsule defect. This case was referred to us by Dr Yogesh Vijay & Surgery was supported by Chambal Fertilizers and Chemical Limited (CFCL), Gadepan, Kota, India. We have been observing pre-existing posterior capsular defects (PPCD) in about 10-15 percent of our pediatric cases. A preexisting posterior capsule defect in cases with congenital cataract is a challenge to the surgeon, and it is important to detect before the surgery. In most cases, it is possible to remove the nucleus and cortex with I/A. In the presence of very dense nuclear cataracts, and when white calcified parts are lodged in the nucleus, however, ultrasound is needed. AquaLase liquefaction (Alcon Laboratories, Inc., Fort Worth, Texas) with a warm-water stream may be useful to remove these dense cataracts. It is important to remove all lens material to minimize postoperative inflammation, which is pronounced in the youngest patients. To reduce opacification of the visual axis after surgery, removal of most lens epithelial cells is important, however, it is almost impossible with the techniques routinely used today. When implanting an IOL, the anterior capsulorrhexis should be round, smaller than the optic, and placed in the center of the capsule. Corticocleaving hydrodissection must be avoided altogether in eyes with preexisting weakness or defect in the posterior capsule, eyes after trauma. Ultimate soft-shell technique (USST): We employ the USST with trypan blue when performing phacoemulsification and IOL implantation in pediatric cases with white cataracts. Healon5 (Abbott Medical Optics, Inc. [AMO], Santa Ana, Calif.) and balanced salt solution are used as part of the USST to facilitate the cataract procedure and enhance its safety. After coating the corneal endothelium with dispersive viscoelastic (Alcon Viscoat), the cohesive viscoadaptive agent (Healon-5) fills the anterior chamber, thereby pressurizing the eye and protecting the corneal endothelial cells. Balanced salt solution is used below the viscoadaptive agent, away from the incision, and creates a surgical operating space with low viscosity. Anterior capsule staining is done using trypan blue by gentally "painting" the anterior capsule. This, in turn, makes capsulorrhexis, hydrodissection (not always necessary in pediatric cases) and later, Healon5 removal, much easier. Complications: Opacification of the visual axis is the most common complication found after cataract surgery in children, particularly in the youngest patients. Even when a posterior capsulorrhexis and a dry anterior vitrectomy are performed, lens epithelial cell growth—on the vitreous surface or on the back of the optic—may be found several months after surgery. An IOL implanted in the bag will decrease or prevent formation of Soemmering's ring, but it is then easier for the epithelial cells to migrate from the periphery to the center of the pupil. After-cataract with membrane formation is an unsolved problem in infants after IOL implantation, and sometimes several interventions are needed. A promising device to fight visual axis opacification in children is the Perfect Capsule (Milvella Inc). A sealed system is created, and the empty lens capsule bag can be rinsed with an antimetabolite, such as 5 fluorouracil. Secondary glaucoma is a common complication and the most sight-threatening. The highest incidence is found in infants younger than 2 months who underwent surgery. Eyes with small corneal size, nuclear cataract, or persistent fetal vasculature are at greatest risk. IOL implantation into the capsular bag seems to inhibit the development of secondary glaucoma. Postoperative inflammation is also an important factor. It is important to remember that when cataract surgery has been performed during the first months of life, intraocular pressure and optic nerves require life-long control. About Dr Suresh K Pandey- A medical graduate of Rani Durgawati University, Medical College, Jabalpur, M.P., India; Dr. Pandey completed his residency in Ophthalmology from prestigious Postgraduate Institute of Medical Education and Research, Chandigarh, India. He worked at Medical University of South Carolina, Charleston, SC, USA, University of Utah, USA & University of Sydney, Australia from1998 to 2006. Dr. Pandey returned to India in 2006 to establish SuVi Eye Institute and Research Center at Kota, Rajasthan, India (www.suvieye.com). Contact Details: Dr. Suresh K Pandey, MS (PGIMER), ASF (USA) Dr. Vidushi Sharma, MD (AIIMS), FRCS (UK) SuVi Eye Institute & Research Centre, Kota, Rajasthan, India Phone +91 744 2433575, +91 9351412449 E-mail: [email protected], www.suvieye.com