About the Book

Presents fundamental component of an atlas that displays images of phacoemulsification surgery in varied situation.
Divided into four sections.
Provides important information on surgical steps and complication management during modern cataract surgery.
Aims to provide accurate and structured approach.
Emphasises on teaching skills which are based on rigorous and current research.
Equips the reader with new information and current concepts in surgical practice.
Provides an interactive DVD-ROM with videos showcasing the surgical aspect of handling numerous clinical condition of phacoemulsification and its complications.

About the Author

Amar Agarwal MS FRCS FRCOphth Priya Narang MS

Table of Contents:
Section 1 PHACO BASICS Amar Agarwal, Priya Narang Diagrammatic Representation of the Connection of Air Pump to the Infusion Bottle 2 Internal Gas Forced Infusion 4 Viscoelastic being Injected with a 26 G Needle Attached to a 1 mL Syringe 6 Framing a Clear Corneal Incision 8 Location of the Incision 9 Size of the Incision 9 Plane of the Incision 10 Capsulorhexis being done with a Bent 26 Gauge Needle 11 Capsulorhexis Flap 12 Vertical Chop 15 Chopping the Nuclear Hemisegments 17 Pull out Nuclear Fragments from Bag and Emulsify 19 Bi-manual Cortical Aspiration 20 Section 2 CHALLENGING CASES Amar Agarwal, Priya Narang Pseudoexfoliation 24 Deposition of Fluffy Amorphous Material Around the Pupil in Pseudoexfoliation 25 Pigment Deposition on Anterior Capsule 27 xviii Phacoemulsification Posterior Synechia 28 Posterior Polar Cataract 30 Trypan Blue Enhanced Capsulorhexis being Performed in a Miotic, Fibrotic Pupil 32 Surgical Tips 33 Subluxation of the Lens and its Management 37 Modified Cionni’s Capsular Tension Ring 39 Lenticular Coloboma 41 Iris Coloboma 43 Soemmering Ring 44 Posterior Lenticonus 46 Section 3 COMPLICATIONS Amar Agarwal, Priya Narang Sleeveless Phacotip Assisted Levitation of Dropped Nucleus (SPAL) Technique—Step 1 50 Spal Technique—Step 2 53 Dropped Nucleus Lying on the Retina 54 Managing the Anterior Chamber Opacities and Herniated Vitreous 55 Posterior Vitrectomy and Phacofragmentation 56 Insulating the Retina with Perfluorocarbon 59 Principle of an Ophthalmic Endoscopic System 60 Removal of Entire Hard Lens Fragment with Perfluorocarbon 64 Management of Lens Coloboma with Glued IOL 69 Dislocated IOL on the Retina 72 Sleeveless Extrusion Cannula for Levitation of Dropped IOL 72 Surgical Technique 73 Perfluorocarbon Liquids 76 25-G Chang Passive-Action IOL Forceps 78 Temporary Haptic Externalization 80 Removal of a Plate Haptic IOL 84 Management of Eyes with two Intraocular Implants 87 Endophthalmitis: Methods of Collecting Specimens 90 Clinical Features 91 Organisms Associated with Acute Postoperative Endophthalmitis 93 Delayed-onset Endophthalmitis 94 Propionibacterium Endophthalmitis 94 Diagnostic Workup and Microbiological Studies 96 Techniques of Specimen Collection 97 Endophthalmitis (Anterior Chamber Washout before Vitrectomy) 99 Antimicrobial Therapy 100 Corticosteroid Therapy 103 Vitrectomy 104 Cystoid Macular Edema 107 Macular Edema 108 Cystoid Macular Edema 108 Cme and Aciol—Possible Pathophysiology 112 Clinical Appearance of CME 113 Contents xix xx Phacoemulsification Macular Function Tests in Cystoid Macular Edema 116 Optical Coherence Tomography in CME 116 Sequela of CME: Post-CME Lamellar Hole 117 Prophylactic Treatment 118 Therapy for Established CME 119 Glued IOL 123 Glued IOL (Continued) 125 Traumatic Iridodialysis 127 Boston Keratoprosthesis (KPro) 129 Decentration of the Capsular Bag and IOL 131 IOL Scaffold 132 Glued IOL Scaffold 134 Pre-Descemet’s Endothelial Keratyoplasty with Glued IOL 137 Surgical Considerations for Combined Procedure 140 Surgical Technique 140 Preoperative and Postoperative Image of Patient of PDEK with Glued IOL 142 Refractive Concern 144 Section 4 MICROINCISION CATARACT SURGERY (PHAKONIT AND MICROPHAKONIT) Amar Agarwal, Priya Narang Clear Corneal Incision Made with a Special Knife (MST, USA) 146 Capsulorhexis Initiated with a Needle 148 MST Rhexis Forceps used to Perform the Rhexis in a Mature Cataract 150 Designs of Agarwal Irrigating Choppers 151 Phakonit Irrigating Chopper and Phako Probe without the Sleeve Inside the Eye 152 Phakonit being done 154 Bimanual Irrigation Aspiration Completed 155 Soft Tip Irrigation-aspiration from MST, USA 156 Thinoptx Roller Cum Injector Inserting the IOL in the Capsular Bag 157 Comparison between Phaco Foldable IOL and Phakonit Thinoptx IOL 158 Microphakonit 160 Microphakonit Completed. The Nucleus has been Removed 162 Bimanual Irrigation-aspiration with the 0.7 mm Set 164 Bimanual Irrigation-aspiration Completed 165 Index 167 Contents xxi