Corneal complication of phacoemulsification Historical cataract surgery lens dislocation Extracapsular cataract extraction Intracapsular cataract extraction.

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Presentation transcript:

Corneal complication of phacoemulsification

Historical cataract surgery lens dislocation Extracapsular cataract extraction Intracapsular cataract extraction Extracapsular cataract extraction

Intraocular lens implantation Phacoemulsification Foldable lenses

Small incision Multifocal lenses Accommodative lenses MIC

Pachymetry Cell counting Ambulating surgery

Shorter the time Faster rehabilitation Better visual acuity Far Near

Phacoemulsification = less complication

Complications Epithelial Traumatic Drags and antiseptics

Incisional Irregular incisional Clear corneal problems Corneal folding Descemets trauma

Stromal dissection Scars Astigmatisem Woumd burn Suture problems

Knifes 1.5 mm, 3.2 mm Shape Sharpness Material

Incision sight Superior Temporal Oblique Incision shape One plane Two planes Tree planes

Irrigation (A.C forming) Stromal hydration Descemets trauma Endothelial trauma

Capsulorehexis Needle Forceps

Hydrodisection Descemets trauma Endothelial trauma

Phaco prop Epithelial Stroma Descemets Endothelial

Fluidic irrigation Severity Time Direction

Phaco Machine Needle Percent Time Continuous pals Endothelial distance In the bag In the papillary plane In the A.C

Direct trauma to the endothelium Chopper Phaco needle

Infection Bacteria wound infection Fungal wound infection Herpetic keratitis

Strile ulcerations and stromal melting Rheumatoid arthritis Collagen vascular disease Keratoconjunctivitis sicca

Symptoms and signs Epithelial defect Punctuate Localized Diffused or huge defect Wound leakage

Corneal edema In the operation time (epithelial) The day after surgery Localized incisional Suture tightness Endothelial damage Near the wound Wound burn

Central corneal edema Endothelial damage Cell slipping Cell death Deep stromal damage Decimates detachments Localized stripping Massive Diagnosis Differentiation with anterior capsul

Total corneal edema In the day after surgery Without hot symptoms

Pigment realizing from the iris Pupillary dilation Iris atrophy toxic keratopathy

Management Epithelial Dry eye Toxicity Exposure lid lag Entropion

Suture tightness

Descemets detachment * In surgical plane * The day after surgery Descemets folding Descemets rolling

Total corneal edema Rollout endophthalmitis IOP Inflammation Cycloplegics Steroids

Astigmatism Suture Persistent

Corneal opacities Corneal scars

Grafting procedures