corneal complication of phacoemulsification historical cataract surgery lens dislocation...

Download Corneal complication of phacoemulsification Historical cataract surgery lens dislocation Extracapsular cataract extraction Intracapsular cataract extraction

Post on 29-Mar-2015

219 views

Category:

Documents

5 download

Embed Size (px)

TRANSCRIPT

  • Slide 1

Slide 2 Corneal complication of phacoemulsification Slide 3 Historical cataract surgery lens dislocation Extracapsular cataract extraction Intracapsular cataract extraction Extracapsular cataract extraction Slide 4 Intraocular lens implantation Phacoemulsification Foldable lenses Slide 5 Small incision Multifocal lenses Accommodative lenses MIC Slide 6 Pachymetry Cell counting Ambulating surgery Slide 7 Shorter the time Faster rehabilitation Better visual acuity Far Near Slide 8 Phacoemulsification = less complication Slide 9 Slide 10 Complications Epithelial Traumatic Drags and antiseptics Slide 11 Incisional Irregular incisional Clear corneal problems Corneal folding Descemets trauma Slide 12 Stromal dissection Scars Astigmatisem Woumd burn Suture problems Slide 13 Knifes 1.5 mm, 3.2 mm Shape Sharpness Material Slide 14 Incision sight Superior Temporal Oblique Incision shape One plane Two planes Tree planes Slide 15 Irrigation (A.C forming) Stromal hydration Descemets trauma Endothelial trauma Slide 16 Capsulorehexis Needle Forceps Slide 17 Hydrodisection Descemets trauma Endothelial trauma Slide 18 Phaco prop Epithelial Stroma Descemets Endothelial Slide 19 Fluidic irrigation Severity Time Direction Slide 20 Phaco Machine Needle Percent Time Continuous pals Endothelial distance In the bag In the papillary plane In the A.C Slide 21 Direct trauma to the endothelium Chopper Phaco needle Slide 22 Infection Bacteria wound infection Fungal wound infection Herpetic keratitis Slide 23 Strile ulcerations and stromal melting Rheumatoid arthritis Collagen vascular disease Keratoconjunctivitis sicca Slide 24 Symptoms and signs Epithelial defect Punctuate Localized Diffused or huge defect Wound leakage Slide 25 Corneal edema In the operation time (epithelial) The day after surgery Localized incisional Suture tightness Endothelial damage Near the wound Wound burn Slide 26 Central corneal edema Endothelial damage Cell slipping Cell death Deep stromal damage Decimates detachments Localized stripping Massive Diagnosis Differentiation with anterior capsul Slide 27 Total corneal edema In the day after surgery Without hot symptoms Slide 28 Pigment realizing from the iris Pupillary dilation Iris atrophy toxic keratopathy Slide 29 Management Epithelial Dry eye Toxicity Exposure lid lag Entropion Slide 30 Suture tightness Slide 31 Descemets detachment * In surgical plane * The day after surgery Descemets folding Descemets rolling Slide 32 Total corneal edema Rollout endophthalmitis IOP Inflammation Cycloplegics Steroids Slide 33 Astigmatism Suture Persistent Slide 34 Corneal opacities Corneal scars Slide 35 Grafting procedures Slide 36