98th Annual Meeting DOG 2000

VV 252

The technology of mechanical fragmentation of hard cataract

K. P. Takhchidi, O. B. Fechin, O. V. Shilovskikh, A. N. Ulianov

Purpose: Evaluation of results and choice of optimal technique for treatment of hard cataract using mechanical phacofragmentation and small tunnel incisions.

Methods: After hydrodissection the nucleus is rotated and its equatoriallayers are removed in order to reduce the nucleus diameter. Small and medium-size nuclei are turned by definite angle with viscoelastic and fragvented with instruments before their removal. In large nuclei before fragmentation and removal a "groove" is formed and the nucleus fragments are divided with micromanipulators.

Results: Mechanical fragmentation was used in 782 operations, including 32 cases where hard nuclei required excessive time of ultrasound exposure for phacoemulsification. Good functional results were achieved in all cases: mean visual acuity was 0.58 uncorrected and 0.85 best corrected. Post -operative astigmatism equaled 0.28 with scleral tunnels and 1.26 with corneal tunnels.

Conclusions: Mechanical fragmentation is the most cost-saving, simple and controlled procedure for cataract surgery .Its technique is defined by the nucleus size. Mechanical phacofragmentation ensures cataract removal through small incisions and achievement ofhigh functional results with low complications rate.

Ekaterinburg Center of IRTC "Eye Microsurgery", 620149 Bardin Str. 4a, Ekaterinburg, Russia