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Recognizing and Managing Bullous Descemet Detachment Secondary to Accidental Hydroseparation During Phacoemulsification/Cataract Surgery by Relaxing Descemetotomy

Conclusions: Rarely stromal hydration performed with an irrigating cannula positioned too close to the posterior stroma can result in hydroseparation of DM creating BDD, seen intraoperatively as a fluid wave propagating across the posterior aspect of the cornea. Large folds, free mobility, and DM tear classically seen with rhegmatogenous Descemet detachment are not seen clinically or on ASOCT in BDD. Pneumodescemetopexy alone cannot resolve BDD because without a DM tear, SDF cannot evacuate. Combining relaxing Descemetotomy with pneumodescemetopexy allows SDF to drain internally and Descemet detachment to resolve. This technique has numerous advantages over classical venting incisions in terms of ease, preferable limbal location, larger incision size, absence of complications such as visual axis scars, irregular astigmatism, epithelial ingrowth, infectious keratitis, etc.
Source: Cornea - Category: Opthalmology Tags: Techniques Source Type: research

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[Toric lens implantation in cataract surgery: Automatic versus manual horizontal axis marking, analysis of 50 cases]. J Fr Ophtalmol. 2018 Feb 06;: Authors: Raucau M, El Chehab H, Agard E, Lagenaite C, Dot C Abstract SUBJECT: The main objective of our study is to evaluate the contribution of automated conjunctival recognition in the alignment of toric implants by comparing the automatic alignment optimized with Callisto™ to the manual marking of the horizontal axis. MATERIALS AND METHODS: We performed a prospective, descriptive, and monocentric study on patients undergoing cataract surge...
Source: Journal Francais d Ophtalmologie - Category: Opthalmology Tags: J Fr Ophtalmol Source Type: research
To compare changes in the shape and astigmatism of the total, anterior, and posterior cornea between eyes with long-length clear corneal incisions (CCIs) and eyes with short-length CCIs in cataract surgery.
Source: Journal of Cataract and Refractive Surgery - Category: Opthalmology Authors: Tags: Article Source Type: research
Toric lens implantation in cataract surgery: Automated versus manual horizontal axis marking, analysis of 50 cases. J Fr Ophtalmol. 2018 Jan 10;: Authors: Raucau M, El Chehab H, Agard E, Lagenaite C, Dot C Abstract SUBJECT: The main objective of our study was to evaluate the contribution of automated conjunctival registration in the alignment of toric intraocular lenses by comparing automated registration optimized with Callisto® to manual marking of the horizontal axis. MATERIALS AND METHODS: We performed a prospective, descriptive, monocentric study on patients undergoing cataract surger...
Source: Journal Francais d Ophtalmologie - Category: Opthalmology Tags: J Fr Ophtalmol Source Type: research
The architecture of clear corneal incisions (CCIs) plays an important role in the outcome of phacoemulsification. Improper CCI construction can lead to a variety of complications, including Descemet's membrane detachments, wound leaks, and excessive surgically induced astigmatism. A previous study demonstrated that it was hard to predictably make manual three-plane, two-plane, or single-plane tunnels with steel or diamond keratomes.1 Femtosecond laser –assisted cataract surgery technology can provide reproducible corneal incisions, capsulotomies, and nuclear fragmentation.2,3 The obvious
Source: Journal of Refractive Surgery - Category: Opthalmology Authors: Source Type: research
Purpose of review There are an increasing number of keratoconic eyes, requiring cataract surgery. We review the preoperative planning, intraoperative options, and postoperative management that aid in successful outcomes. Recent findings Management of keratoconic eyes requiring cataract surgery requires a multifaceted approach. Preoperatively, corneal crosslinking and intrastromal corneal ring segments can be considered in order to provide stable keratometry values for intraocular lens (IOL) calculations. Deciding between toric and monofocal IOLs requires a thorough evaluation. Intraoperatively, the decision of clear c...
Source: Current Opinion in Ophthalmology - Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Purpose of review Manual small incision cataract surgery (MSICS) has recently gone through much refinement and fine tuning. It is often taken as an alternate option for phacoemulsification, especially in developing country. This review will present some insight on its applications especially for developed nations. The role of MSCIS in tackling complex cataracts with stony hard nucleus is fairly established. The role of training residents with MSCIS has certain advantages though debatable. Recent findings MSCIS is much faster and cost-effective surgical technique often possible in suboptimal condition and avoids the ca...
Source: Current Opinion in Ophthalmology - Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Purpose of review To evaluate and summarize literature from the past 18 months reporting advancements and issues in astigmatism assessment prior to cataract surgery. Recent findings New and updated toric calculators and regression formulas offer the opportunity for more accurate lens selection for our patients. Concurrently, improvements in topographic evaluation of corneal keratometry have allowed for a decrease in unplanned residual corneal astigmatism. Measuring posterior corneal astigmatism is especially valuable in eyes with keratoconus when planning to implant toric intraocular lens (IOL) and now allows access t...
Source: Current Opinion in Ophthalmology - Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Purpose of review Achieving secure wound closure in clear corneal incision cataract surgery remains highly desired for its role in reducing infection risk and leak-related complications, including hypotony, corneal edema, and lens dislocation. Although classic techniques of stromal hydration or wound suturing represent traditional approaches, the introduction of newer and more effective ocular surface adhesives has increased the options that are available. This review aims to provide an update on the peer-reviewed literature regarding wound closure and the currently available and investigational tissue adhesives used to ...
Source: Current Opinion in Ophthalmology - Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Purpose of review To evaluate and summarize literature from the past 18 months reporting advancements and issues in astigmatism assessment prior to cataract surgery. Recent findings New and updated toric calculators and regression formulas offer the opportunity for more accurate lens selection for our patients. Concurrently, improvements in topographic evaluation of corneal keratometry have allowed for a decrease in unplanned residual corneal astigmatism. Measuring posterior corneal astigmatism is especially valuable in eyes with keratoconus when planning to implant toric intraocular lens (IOL) and now allows access t...
Source: Current Opinion in Ophthalmology - Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Purpose of review Achieving secure wound closure in clear corneal incision cataract surgery remains highly desired for its role in reducing infection risk and leak-related complications, including hypotony, corneal edema, and lens dislocation. Although classic techniques of stromal hydration or wound suturing represent traditional approaches, the introduction of newer and more effective ocular surface adhesives has increased the options that are available. This review aims to provide an update on the peer-reviewed literature regarding wound closure and the currently available and investigational tissue adhesives used to ...
Source: Current Opinion in Ophthalmology - Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
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