Complications such as perforations have occurred.
ITRACE ZALDIVAR CALIPER MANUAL
8 Corneal incisions are typically superior to manual incisions but are then manipulated during surgery during implantation, causing edema similar to that caused by manual incisions. 7 Patient movement during surgery has resulted in grid patterns imprinted on corneas. Suction loss is typically noncomplicating but may be serious. conventional refractive cataract surgeryĬomplications are rare but may occur. 5 Total treatment times are longer than manual procedures. Debate continues regarding whether femtosecond laser-assisted cataract surgery results in superior refractive outcomes, reduced phaco time, 2 improvement in the capsulotomy and corneal incisions, 3,4 and corneal endothelial cell loss. Zeimer FEMTO LVD Z8 (Zeimer Group) received CE approval in Europe in May 2014 for clear corneal incisions, arcuate incisions, capsulotomy, and lens fragmentation, but applications are currently limited to corneal and presbyopia in the U.S.
Most systems create the capsulorhexis, fragment the lens to facilitate removal, and create corneal incisions (see Figure 1). These include Catalys (Optimedica), LenSx (Alcon Laboratories), LensAR (Lensar) and Victus (Technolas). Next: Femtosecond laser-assisted phacoemulsificationįemtosecond laser-assisted phacoemulsificationįour platforms are now fully approved in the U.S. New systems include Centurion Vision System (Alcon), WhiteStar Signature System (Abbot Medical Optics), Stellaris Vision Enhancement System (Bausch + Lomb,), and Ocusystem ART Phacoemulsifier (Surgical Design)
Systems that incorporate both pumping types are typically preferred. They generate much higher flow rates than peristaltic pumps and require lower vacuum levels than peristaltic systems. Venturi pumps create optimal fluidic conditions for segment removal in a stable anterior chamber. 1Ī high and uninterrupted flow rate is ideal to draw segments out of the capsular bag while maintaining the tip in the iris plane. Variable control is important for successful outcomes, particularly for surgeons who desire greater control for femtosecond laser-assisted procedures (which require less power), and dense cataracts (requiring more power). If pressure is maintained at a constant level, the anterior chamber is more stable. Swartz: Effectively comanaging femtosecond laser-assisted cataract surgeryįluidics is the dynamic between the fluid entering the eye and the intraocular pressure (IOP) during cataract surgery. The tip has a hole, which allows the fragmented lens as well as irrigation solution (BSS) to be aspirated. The phaco tip, or fragmentation needle, vibrates at an ultrasonic frequency and emulsifies a cataract when connected to the ultrasonic hand piece. The ultrasound hand piece is connected to a phaco system, which drives the procedure using settings as dictated by the surgeon. Modern lens removal occurs using phacoemulsification (phaco), which incorporates ultrasound to emulsify and vacuum to extract a cataractous lens.
Incisions are often fewer than 3 mm because implants are engineered to be placed in smaller incisions. This includes surgical systems providing better control, lasers to perform manual techniques, and intraoperative evaluation to evaluate surgical endpoints before the patient leaves the operating room (OR).Ĭataract surgery involves a corneal incision as well as a paracentsis, removal of the cataract and implantation of the intraocular lens (IOL), while maintaining the pressure in the eye. Modern ophthalmic cataract surgery now employs sophisticated techniques to improve outcomes and patient satisfaction.
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