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    Capsulorhexis in Phacoemulsification Surgery

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    Pawan Jarwal
    Capsulorhexis is a technique used to remove the lens capsule during cataract surgery through creating a continuous curvilinear opening. It involves using shear and stretch forces to tear a circular portion of the anterior lens capsule. The capsulorhexis opening allows for removal of the lens nucleus and implantation of an intraocular lens. Complications can occur if the capsulorhexis has a small diameter, such as anterior capsule contracture, zonular stretching, or intraocular lens complications.

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    Capsulorhexis in Phacoemulsification Surgery

    Uploaded by

    Pawan Jarwal
    98 views24 pages
    Capsulorhexis is a technique used to remove the lens capsule during cataract surgery through creating a continuous curvilinear opening. It involves using shear and stretch forces to tear a circular portion of the anterior lens capsule. The capsulorhexis opening allows for removal of the lens nucleus and implantation of an intraocular lens. Complications can occur if the capsulorhexis has a small diameter, such as anterior capsule contracture, zonular stretching, or intraocular lens complications.

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    Capsulorhexis is a technique used to remove the lens capsule during cataract surgery through creating a continuous curvilinear opening. It involves using shear and stretch forces to tear a circular portion of the anterior lens capsule. The capsulorhexis opening allows for removal of the lens nucleus and implantation of an intraocular lens. Complications can occur if the capsulorhexis has a small diameter, such as anterior capsule contracture, zonular stretching, or intraocular lens complications.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    98 views24 pages

    Capsulorhexis in Phacoemulsification Surgery

    Uploaded by

    Pawan Jarwal
    Capsulorhexis is a technique used to remove the lens capsule during cataract surgery through creating a continuous curvilinear opening. It involves using shear and stretch forces to tear a circular portion of the anterior lens capsule. The capsulorhexis opening allows for removal of the lens nucleus and implantation of an intraocular lens. Complications can occur if the capsulorhexis has a small diameter, such as anterior capsule contracture, zonular stretching, or intraocular lens complications.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 24

    CAPSULORHEXIS IN

    PHACOEMULSIFICATION SURGERY

    BY DR.ARPITA PATEL
    Capsulorhexis is a technique used to remove the
    lens capsule during cataract surgery.
    It is also termed Continuous Curvilinear
    Capsulorhexis' (CCC), the term describing the
    exact surgical technique. Shear and stretch forces
    are used. Howard Gimbel was the pioneer in the
    technique.
    In order to remove a cataract with modern
    techniques, the capsule of the lens must be
    opened.
    • The usual method is to use the same bent
    needle to begin a tear in the capsule, and then
    either guide the edge with the same needle
    around the anterior surface, or use a special
    forceps to do the same.
    • There are advantages and disadvantages of
    both approaches, and most surgeons will use
    both instruments as the situation requires.
    • A capsulotomy (rarely known as cystotomy) is
    a procedure to open a portion of the lens
    capsule, using an instrument called a
    cystotome.[18] An anterior capsulotomy refers
    to the opening of the front portion of the lens
    capsule, whereas a posterior capsulotomy
    refers to the opening of the back portion of
    the lens capsule.
    In phacoemulsification, the surgeon
    performs an anterior continuous
    curvilinear capsulorhexis, to create a round
    and smooth opening through which the
    lens nucleus can be emulsified and the
    intraocular lens implant inserted.
    • Small diameter anterior capsulorhexis - May
    be complicated with purse string anterior
    capsule contracture which may lead to:
    – Reduce vision
    – Zonular stretching
    – IOL compression
    – IOL dislocation
    – Ciliary body traction
    – Hypotonous choroidal effusions
    Dynamics of capsulorhexis

    • Strip of material without any forces acting on


    it,interdigited central portion represents the
    intermolecular attractions at this location.
    • Material with very mild force.
    s

    • Stress and strain have important role in it.


    • Stress increased so that material begins to deform –
    stretching at the centre
    • If strain is increased just beyond a material’s elastic
    limit, material will be permanently deformed even
    after stress is discontinued,
    • If strain further increases beyond elastic limit,
    stress usually increases slightly but then
    decreases as the material’s breaking point is
    approached.
    • When this point is reached, the intermolecular
    bonds r broken and material tears apart.
    Shearing principles
    • X-stationary n material is engeged with an
    instrument at blue dot and pulled with vector
    force t.
    • No tearing while y is pulled from a toward b,
    strain and stress in the material progressively
    increase.
    • When point b is reached strain passes the
    material’s breaking point and ripping begins in
    arrow noted by E
    • Point A just ripped apart
    • Point B undergoing strain
    • Point C some stress without any deformation
    • Point D no forces acting on it, now has stress
    • Ripping the capsule is less desirable than
    shearing because 1)tear tends to
    uncontrollably extend when ripping even
    when the instrument is held stationary.
    Capsulorhexis with ripping
    THANK YOU
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    • Surgery & Complications
    • Small diameter anterior capsulorhexis. May be complicated with purse string anterior capsule contracture which may lead to:
    – Reduce vision
    – Zonular stretching
    – IOL compression
    – IOL dislocation
    – Ciliary body traction
    – Hypotonous choroidal effusions
    • Treatment: Neodynium: YAG laser anterior capsulotomy for significant anterior capsule contracture.

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