RESUMEN
Longer follow-up studies available to date on the phakectomy technique combined with a planned shallow anterior vitrectomy for the removal of congenital or juvenile cataract reveal the method to be justified. The morbidity of multiple reoperations for residual after-cataract membrane has been significantly reduced (6 of 163 eyes or 3.6%). Only two retinal detachments (1.2%) have occurred; both were successfully attached. The visual status has been improved both quantitatively (visual acuity) and most importantly qualitatively (brighter images, wider field of view, and enhanced vision under poorly lighted conditions). No eyes have been made worse.
Asunto(s)
Extracción de Catarata/métodos , Catarata/congénito , Cuerpo Vítreo/cirugía , Adolescente , Adulto , Afaquia Poscatarata/complicaciones , Niño , Preescolar , Estudios de Seguimiento , Humanos , Lactante , Métodos , Desprendimiento de Retina/cirugíaRESUMEN
Pars plana lensectomy, wherein the entire lens within the pupillary area (the anterior capsule, anterior cortex, nucleus, posterior cortex, and posterior capsule) is removed, is now a well-established technique. It is to be considered as a method of choice for the removal of presenile cataracts in patients under the age of 40, developmental cataracts, cataracta complicata secondary to uveitis, subluxated and luxated cataracts. Pars plana lensectomy of the senile cataract is limited to a grade 2 nuclear sclerosis on a scale of 4. The use of ultrasonic instrumentation via the pars plana in conjunction with vitreous instrumentation permits the removal of the grade 3 nuclear sclerotic cataract. A pars plana two-instrument technique is used for the extraction of the totally luxated senile cataract no matter how sclerotic the nucleus may be.
Asunto(s)
Extracción de Catarata/métodos , Cuerpo Vítreo/cirugía , Adulto , Factores de Edad , Extracción de Catarata/efectos adversos , Humanos , Microcirugia/instrumentación , Oftalmología/instrumentación , Terapia por Ultrasonido/métodosRESUMEN
A double-edged cutting blade oscillates between a clockwise and a counter-clockwise high speed rotation without completing a full revolution. This imparts a great mechanicaldvantage and safety to the instrument's cutting efficiency. The cutter may also be used with a continuous high speed clockwise rotation. Multiple interchangeable probe tips are used that are of either double- or triple-walled construction. A fiber-optic light pipe surrounds the probe tip used for deep vitrectomy in conjunction with an irrigated fundus lens. A film will illustrate the use of the roto-extractor in two diabetic patients with old unabsorbed vitreous hemorrhage and membranes. In the first case, a pars plana incision was used for vitrectomy in conjunction with a cataract extraction. In the second case, the para plana vitrectomy was combined with an optical iridectomy necessitated by the presence of an updrawn pupil following previous cataract extraction complicated by vitreous loss. To date, 12 roto-extractors have been distributed to 12 various teaching institutions throughout the United States.