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The phacoemulsifier provides controlled irrigation-aspiration and Operations Upon the Eyeball and its Adnexa 463 phacoemulsification medicine xalatan generic nitazoxanide 500mg. The phacoemulsification is performed by a phaco handpiece the tip of which vibrates 28000-60000 cycles per second symptoms walking pneumonia cheap 500mg nitazoxanide. Side-port entry: A side-port entry is made for filling the anterior chamber with viscoelastic substance medications via g tube purchase nitazoxanide 500 mg. Nuclear emulsification: It is done by ultrasonic power of phaco handpiece either in the capsular bag or in the iris plane symptoms irritable bowel syndrome 500mg nitazoxanide. In the divide and conquer technique a deep linear groove is sculpted in the nucleus. After the rotation of the nucleus to 90 degrees a further trenching at right angle to the previous groove is performed. Then the nucleus is divided into 4 quadrants with the help of a chopper and phaco tip. In direct chop technique the nucleus is divided into two heminuclei using the phacoemulsification handpiece and a chopper. Cortical cleaning: the remaining lens cortex is aspirated with the help of a coaxial or bimanual irrigation-aspiration canula. Lens implantation: A posterior chamber foldable lens can be implanted without enlarging the corneal incision. Small incision, sutureless surgery Relatively safe surgery Maintains the anterior chamber throughout the surgery Minimum postoperative astigmatism Rapid convalescence Complications of Cataract Surgery Intraoperative Complications the common intraoperative complications of cataract surgery are summarized in Table 27. Retrobulbar hemorrhage may develop following the retrobulbar or peribulbar injection for regional anesthesia. Hyphema appears during the surgery owing to oozing from the corneoscleral wound or from the traumatized iris. The oozing points on the sclera Advantages of Phacoemulsification Phacoemulsification is currently the most popular surgical procedure for the removal of cataract. They include high cost of the phaco machine, difficult technique requiring training under an expert, relatively long learning curve, and possibility of complications in hard cataract and compromised cornea. Postoperative Complications Depending on the time of occurrence, the postoperative complications of cataract surgery may be divided into two categories-early and late. Vitreous presentation in the anterior chamber even before the extraction of the lens may occur in a traumatized eye or due to previous poorly performed intraocular surgery. Prolapse of the vitreous after the nuclear delivery can happen because of posterior capsular rent that occurs most commonly during cortical irrigation-aspiration. In these cases one should proceed slowly, clear the vitreous from the anterior chamber and avoid any traction on the vitreous base or excessive hydration of the vitreous. It can be a total lens dislocation due to zonular weakness or just a subluxation because of undue pressure on the zonule. Even the nuclear fragments may get posteriorly dislocated in the event of posterior capsular tear. Expulsive hemorrhage, though rare, can occur during or soon after the cataract surgery. Hypertension, arteriosclerosis, diabetes and raised intraocular pressure are known risk factors. Severe ocular pain, soakage of the eye pad and prolapse of the vitreous and the uveal tissue in the wound are the presenting features. Suprachoroidal drainage of the blood and reformation of the anterior Early Postoperative Complications Early postoperative complications of cataract surgery are listed in Table 27. Striate keratitis Corneal edema Prolapse of iris Hyphema Anterior uveitis Delayed formation of the anterior chamber Early endophthalmitis Striate keratitis develops due to damage to the corneal endothelium during excessive manipulation within the anterior chamber or by prolonged and repeated irrigation. It usually disappears within a few days, but causes significant loss of corneal endothelial cells. Once it is noticed without any signs of infection it must be reposed taking aseptic precautions and additional stitches are placed to repair the wound.

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