CataractCoach™ 2086: too mushy to chop, so do tilt and tumble скачать в хорошем качестве

CataractCoach™ 2086: too mushy to chop, so do tilt and tumble

This is a complete cataract case featuring a nucleus that is too mushy to chop, so I revert to the tilt and tumble technique described years ago by Dr Dick Lindstrom. This makes for an efficient removal of the lens and still delivers a clear cornea for this soft nucleus. This technique involves tilting the nucleus out of the capsular bag and into the iris plane. The phaco probe is then used to emulsify the nucleus with the second instrument stabilizing the nucleus and feeding it into the phaco needle tip. No chopping or mechanical disassembly of the nucleus is required and only one phaco setting is needed (high vacuum, high flow, moderate phaco power). Tilt and Tumble is most suitable for soft to moderate nuclear densities, which is the most common type of cataract encountered in the USA. As Dr Linstrom says, “Tilt and Tumble phacoemulsification is a supracapsular approach that is quite easy and straightforward to learn. It is especially helpful for the softer nucleus, but the skilled surgeon can use it for firmer nuclei using modern viscoelastics, bevel down and a second instrument to hold the nucleus back from the cornea. A tilted nucleus with the phacoemulsification probe held above the iris plane is also helpful in IFIS and small pupil cases. Many of my fellows have adopted this approach for the majority  of their cases, as have I.”