Management of posterior capsule rupture during phacoemulsification using the dry technique
Identifieur interne : 003429 ( Istex/Corpus ); précédent : 003428; suivant : 003430Management of posterior capsule rupture during phacoemulsification using the dry technique
Auteurs : Junsuke Akura ; Shiro Hatta ; Shuzo Kaneda ; Mika Ishihara ; Kazuki Matsuura ; Akihiko TamaiSource :
- Journal of Cataract & Refractive Surgery [ 0886-3350 ] ; 2000.
Abstract
To manage posterior capsule rupture during phacoemulsification, we use a dry technique in which all procedures are performed without an irrigation/aspiration system. The dry technique is characterized by (1) continuous viscoelastic injection instead of fluid irrigation to maintain anterior chamber depth with the posterior capsule and vitreous located posteriorly and (2) static removal of most residual lens material by viscoexpression and/or manual small incision extracapsular cataract extraction without aspiration and dynamic water flow. In 16 cases of posterior capsule rupture managed using the dry technique, the residual nucleus and cortex were readily removed with minimum extension of the ruptured area and new vitreous loss. Although large amounts of viscoelastic material (mean 5.8 mL) were required, rapid and stable visual recovery was comparable to that in patients having uneventful surgery. The dry system is a safe and reliable technique for managing posterior capsule rupture during phacoemulsification.
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DOI: 10.1016/S0886-3350(00)00838-5
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Kaneda</name><affiliation><mods:affiliation>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</mods:affiliation></affiliation></author><author><name sortKey="Ishihara, Mika" sort="Ishihara, Mika" uniqKey="Ishihara M" first="Mika" last="Ishihara">Mika Ishihara</name><affiliation><mods:affiliation>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</mods:affiliation></affiliation></author><author><name sortKey="Matsuura, Kazuki" sort="Matsuura, Kazuki" uniqKey="Matsuura K" first="Kazuki" last="Matsuura">Kazuki Matsuura</name><affiliation><mods:affiliation>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</mods:affiliation></affiliation></author><author><name sortKey="Tamai, Akihiko" sort="Tamai, Akihiko" uniqKey="Tamai A" first="Akihiko" last="Tamai">Akihiko Tamai</name><affiliation><mods:affiliation>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago 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Japan</mods:affiliation></affiliation></author><author><name sortKey="Hatta, Shiro" sort="Hatta, Shiro" uniqKey="Hatta S" first="Shiro" last="Hatta">Shiro Hatta</name><affiliation><mods:affiliation>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</mods:affiliation></affiliation></author><author><name sortKey="Kaneda, Shuzo" sort="Kaneda, Shuzo" uniqKey="Kaneda S" first="Shuzo" last="Kaneda">Shuzo Kaneda</name><affiliation><mods:affiliation>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</mods:affiliation></affiliation></author><author><name sortKey="Ishihara, Mika" sort="Ishihara, Mika" uniqKey="Ishihara M" first="Mika" last="Ishihara">Mika Ishihara</name><affiliation><mods:affiliation>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</mods:affiliation></affiliation></author><author><name sortKey="Matsuura, Kazuki" sort="Matsuura, Kazuki" uniqKey="Matsuura K" first="Kazuki" last="Matsuura">Kazuki Matsuura</name><affiliation><mods:affiliation>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</mods:affiliation></affiliation></author><author><name sortKey="Tamai, Akihiko" sort="Tamai, Akihiko" uniqKey="Tamai A" first="Akihiko" last="Tamai">Akihiko Tamai</name><affiliation><mods:affiliation>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Cataract & Refractive Surgery</title><title level="j" type="abbrev">JCRS</title><idno type="ISSN">0886-3350</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2000">2000</date><biblScope unit="volume">27</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="982">982</biblScope><biblScope unit="page" to="989">989</biblScope></imprint><idno type="ISSN">0886-3350</idno></series><idno type="istex">A85E9CCBF9C512398E71FC8ADC365BA4C0D8FD35</idno><idno type="DOI">10.1016/S0886-3350(00)00838-5</idno><idno type="PII">S0886-3350(00)00838-5</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0886-3350</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">To manage posterior capsule rupture during phacoemulsification, we use a dry technique in which all procedures are performed without an irrigation/aspiration system. The dry technique is characterized by (1) continuous viscoelastic injection instead of fluid irrigation to maintain anterior chamber depth with the posterior capsule and vitreous located posteriorly and (2) static removal of most residual lens material by viscoexpression and/or manual small incision extracapsular cataract extraction without aspiration and dynamic water flow. In 16 cases of posterior capsule rupture managed using the dry technique, the residual nucleus and cortex were readily removed with minimum extension of the ruptured area and new vitreous loss. Although large amounts of viscoelastic material (mean 5.8 mL) were required, rapid and stable visual recovery was comparable to that in patients having uneventful surgery. The dry system is a safe and reliable technique for managing posterior capsule rupture during phacoemulsification.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Junsuke Akura MD</name><affiliations><json:string>E-mail: akura@skyblue.ocn.ne.jp</json:string><json:string>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</json:string></affiliations></json:item><json:item><name>Shiro Hatta MD</name><affiliations><json:string>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</json:string></affiliations></json:item><json:item><name>Shuzo Kaneda MD</name><affiliations><json:string>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</json:string></affiliations></json:item><json:item><name>Mika Ishihara MD</name><affiliations><json:string>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</json:string></affiliations></json:item><json:item><name>Kazuki Matsuura MD</name><affiliations><json:string>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</json:string></affiliations></json:item><json:item><name>Akihiko Tamai MD</name><affiliations><json:string>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</json:string></affiliations></json:item></author><language><json:string>eng</json:string></language><abstract>To manage posterior capsule rupture during phacoemulsification, we use a dry technique in which all procedures are performed without an irrigation/aspiration system. The dry technique is characterized by (1) continuous viscoelastic injection instead of fluid irrigation to maintain anterior chamber depth with the posterior capsule and vitreous located posteriorly and (2) static removal of most residual lens material by viscoexpression and/or manual small incision extracapsular cataract extraction without aspiration and dynamic water flow. In 16 cases of posterior capsule rupture managed using the dry technique, the residual nucleus and cortex were readily removed with minimum extension of the ruptured area and new vitreous loss. Although large amounts of viscoelastic material (mean 5.8 mL) were required, rapid and stable visual recovery was comparable to that in patients having uneventful surgery. The dry system is a safe and reliable technique for managing posterior capsule rupture during phacoemulsification.</abstract><qualityIndicators><score>5.627</score><pdfVersion>1.2</pdfVersion><pdfPageSize>586 x 785 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1024</abstractCharCount><pdfWordCount>3887</pdfWordCount><pdfCharCount>24573</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>145</abstractWordCount></qualityIndicators><title>Management of posterior capsule rupture during phacoemulsification using the dry technique</title><pii><json:string>S0886-3350(00)00838-5</json:string></pii><genre><json:string>brief communication</json:string></genre><serie><pages><last>400</last><first>389</first></pages><genre></genre><language><json:string>unknown</json:string></language><title>Textbook of Advanced Phacoemulsification Techniques</title></serie><host><volume>27</volume><pii><json:string>S0886-3350(00)X0027-2</json:string></pii><pages><last>989</last><first>982</first></pages><issn><json:string>0886-3350</json:string></issn><issue>7</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><title>Journal of Cataract & Refractive Surgery</title><publicationDate>2001</publicationDate></host><categories><wos><json:string>OPHTHALMOLOGY</json:string><json:string>SURGERY</json:string></wos></categories><publicationDate>2000</publicationDate><copyrightDate>2001</copyrightDate><doi><json:string>10.1016/S0886-3350(00)00838-5</json:string></doi><id>A85E9CCBF9C512398E71FC8ADC365BA4C0D8FD35</id><score>1</score><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/A85E9CCBF9C512398E71FC8ADC365BA4C0D8FD35/fulltext/pdf</uri></json:item><json:item><original>true</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/A85E9CCBF9C512398E71FC8ADC365BA4C0D8FD35/fulltext/txt</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/A85E9CCBF9C512398E71FC8ADC365BA4C0D8FD35/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/A85E9CCBF9C512398E71FC8ADC365BA4C0D8FD35/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Management of posterior capsule rupture during phacoemulsification using the dry technique</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>ELSEVIER</p></availability><date>2001</date></publicationStmt><notesStmt><note>None of the authors has a financial or proprietary interest in any material or method mentioned.</note><note type="content">Figure 1: (Akura) To extract a relatively large nuclear fragment, the fragment is smoothly removed from a narrow scleral tunnel using a claw vectis because it is fixed at the claw in the tunnel. During nucleus removal, viscoelastic material is constantly injected through the vectis to maintain anterior chamber depth with the posterior capsule and vitreous located posteriorly.</note><note type="content">Figure 2A: (Akura) To isolate the epinucleus or large residual cortex from the capsule, viscoelastic material is injected into several sites between the anterior capsule and these structures. The structures are mechanically separated from the capsule by a slow stream of viscoelastic material (viscodissection).</note><note type="content">Figure 2B: (Akura) To extract a relatively small nuclear fragment, epinucleus, or large residual cortex, viscoelastic material is injected into the site below these structures and opposite the wound, producing a slow stream toward the wound. The stream leads these structures to the wound. Then, the wound is pushed down while viscoelastic material is injected to allow passage of the structures along with outflow of the viscoelastic material (viscoexpression). The viscoelastic material is used as a mechanical instrument to extract lens materials from the wound and to push the posterior capsule and vitreous downward.</note><note type="content">Figure 3: (Akura) To aspirate cortex attached to the capsule, an assistant continuously injects viscoelastic material via the corneal paracentesis according to the surgeon’s request. The cortex attached to the capsule is manually aspirated using a Simcoe cannula from 1 or 2 side-port incisions in a closed environment (dry Simcoe).</note><note type="content">Figure 4: (Akura) The extent of posterior capsule rupture in the pupil area at the time of its recognition (dotted line) and at the end of surgery (solid line) and the shape of residual nucleus at the time of capsule rupture. Vitreous was present in the anterior chamber in Case 6 and was prolapsed extraocularly in Case 10 when the capsule rupture was recognized.</note><note type="content">Table 1: Time of capsule rupture, treatment after rupture, BCVA, and postoperative complications.legend</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Management of posterior capsule rupture during phacoemulsification using the dry technique</title><author><persName><forename type="first">Junsuke</forename><surname>Akura</surname></persName><roleName type="degree">MD</roleName><email>akura@skyblue.ocn.ne.jp</email><note type="biography">Reprint requests to Junsuke Akura, MD, Kushimoto Rehabilitation Center, 259-6 Kushimoto, Kushimoto-cho, Nishimuro-gun, Wakayama-ken, 649-3503, Japan</note><affiliation>Reprint requests to Junsuke Akura, MD, Kushimoto Rehabilitation Center, 259-6 Kushimoto, Kushimoto-cho, Nishimuro-gun, Wakayama-ken, 649-3503, Japan</affiliation><affiliation>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</affiliation></author><author><persName><forename type="first">Shiro</forename><surname>Hatta</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</affiliation></author><author><persName><forename type="first">Shuzo</forename><surname>Kaneda</surname></persName><roleName type="degree">MD</roleName><affiliation>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</affiliation></author><author><persName><forename type="first">Mika</forename><surname>Ishihara</surname></persName><roleName type="degree">MD</roleName><affiliation>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</affiliation></author><author><persName><forename type="first">Kazuki</forename><surname>Matsuura</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</affiliation></author><author><persName><forename type="first">Akihiko</forename><surname>Tamai</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</affiliation></author></analytic><monogr><title level="j">Journal of Cataract & Refractive Surgery</title><title level="j" type="abbrev">JCRS</title><idno type="pISSN">0886-3350</idno><idno type="PII">S0886-3350(00)X0027-2</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2000"></date><biblScope unit="volume">27</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="982">982</biblScope><biblScope unit="page" to="989">989</biblScope></imprint></monogr><idno type="istex">A85E9CCBF9C512398E71FC8ADC365BA4C0D8FD35</idno><idno type="DOI">10.1016/S0886-3350(00)00838-5</idno><idno type="PII">S0886-3350(00)00838-5</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2001</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>To manage posterior capsule rupture during phacoemulsification, we use a dry technique in which all procedures are performed without an irrigation/aspiration system. The dry technique is characterized by (1) continuous viscoelastic injection instead of fluid irrigation to maintain anterior chamber depth with the posterior capsule and vitreous located posteriorly and (2) static removal of most residual lens material by viscoexpression and/or manual small incision extracapsular cataract extraction without aspiration and dynamic water flow. In 16 cases of posterior capsule rupture managed using the dry technique, the residual nucleus and cortex were readily removed with minimum extension of the ruptured area and new vitreous loss. Although large amounts of viscoelastic material (mean 5.8 mL) were required, rapid and stable visual recovery was comparable to that in patients having uneventful surgery. The dry system is a safe and reliable technique for managing posterior capsule rupture during phacoemulsification.</p></abstract></profileDesc><revisionDesc><change when="2000-11-09">Registration</change><change when="2000">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: ce:floats; body; tail"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"><istex:entity SYSTEM="gr1" NDATA="IMAGE" name="GR1"></istex:entity><istex:entity SYSTEM="gr2a" NDATA="IMAGE" name="GR2A"></istex:entity><istex:entity SYSTEM="gr2b" NDATA="IMAGE" name="GR2B"></istex:entity><istex:entity SYSTEM="gr3" NDATA="IMAGE" name="GR3"></istex:entity><istex:entity SYSTEM="gr4" NDATA="IMAGE" name="GR4"></istex:entity></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="sco" xml:lang="en"><item-info><jid>JCRS</jid><aid>1010</aid><ce:pii>S0886-3350(00)00838-5</ce:pii><ce:doi>10.1016/S0886-3350(00)00838-5</ce:doi><ce:copyright type="full-transfer" year="2001">Elsevier Science Inc.</ce:copyright></item-info><head><ce:article-footnote><ce:label>☆</ce:label><ce:note-para>None of the authors has a financial or proprietary interest in any material or method mentioned.</ce:note-para></ce:article-footnote><ce:title>Management of posterior capsule rupture during phacoemulsification using the dry technique</ce:title><ce:author-group><ce:author><ce:given-name>Junsuke</ce:given-name><ce:surname>Akura</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup>a</ce:sup></ce:cross-ref><ce:cross-ref refid="CORR1">*</ce:cross-ref><ce:e-address>akura@skyblue.ocn.ne.jp</ce:e-address></ce:author><ce:author><ce:given-name>Shiro</ce:given-name><ce:surname>Hatta</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF2"><ce:sup>b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Shuzo</ce:given-name><ce:surname>Kaneda</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup>a</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Mika</ce:given-name><ce:surname>Ishihara</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup>a</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Kazuki</ce:given-name><ce:surname>Matsuura</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF2"><ce:sup>b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Akihiko</ce:given-name><ce:surname>Tamai</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF2"><ce:sup>b</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="AFF1"><ce:label>a</ce:label><ce:textfn>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</ce:textfn></ce:affiliation><ce:affiliation id="AFF2"><ce:label>b</ce:label><ce:textfn>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</ce:textfn></ce:affiliation><ce:correspondence id="CORR1"><ce:label>*</ce:label><ce:text>Reprint requests to Junsuke Akura, MD, Kushimoto Rehabilitation Center, 259-6 Kushimoto, Kushimoto-cho, Nishimuro-gun, Wakayama-ken, 649-3503, Japan</ce:text></ce:correspondence></ce:author-group><ce:date-accepted day="9" month="11" year="2000"></ce:date-accepted><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para>To manage posterior capsule rupture during phacoemulsification, we use a dry technique in which all procedures are performed without an irrigation/aspiration system. The dry technique is characterized by (1) continuous viscoelastic injection instead of fluid irrigation to maintain anterior chamber depth with the posterior capsule and vitreous located posteriorly and (2) static removal of most residual lens material by viscoexpression and/or manual small incision extracapsular cataract extraction without aspiration and dynamic water flow. In 16 cases of posterior capsule rupture managed using the dry technique, the residual nucleus and cortex were readily removed with minimum extension of the ruptured area and new vitreous loss. Although large amounts of viscoelastic material (mean 5.8 mL) were required, rapid and stable visual recovery was comparable to that in patients having uneventful surgery. The dry system is a safe and reliable technique for managing posterior capsule rupture during phacoemulsification.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Management of posterior capsule rupture during phacoemulsification using the dry technique</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Management of posterior capsule rupture during phacoemulsification using the dry technique</title></titleInfo><name type="personal"><namePart type="given">Junsuke</namePart><namePart type="family">Akura</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>E-mail: akura@skyblue.ocn.ne.jp</affiliation><affiliation>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</affiliation><description>Reprint requests to Junsuke Akura, MD, Kushimoto Rehabilitation Center, 259-6 Kushimoto, Kushimoto-cho, Nishimuro-gun, Wakayama-ken, 649-3503, Japan</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Shiro</namePart><namePart type="family">Hatta</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Shuzo</namePart><namePart type="family">Kaneda</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mika</namePart><namePart type="family">Ishihara</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Kushimoto Rehabilitation Center, Kushimoto, (Akura, Kaneda, Ishihara), Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kazuki</namePart><namePart type="family">Matsuura</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Akihiko</namePart><namePart type="family">Tamai</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Ophthalmology, Tottori University Faculty of Medicine, Yonago (Hatta, Matsuura, Tamai), Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="brief communication" displayLabel="Short communication"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">2000</dateIssued><dateValid encoding="w3cdtf">2000-11-09</dateValid><copyrightDate encoding="w3cdtf">2001</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">To manage posterior capsule rupture during phacoemulsification, we use a dry technique in which all procedures are performed without an irrigation/aspiration system. The dry technique is characterized by (1) continuous viscoelastic injection instead of fluid irrigation to maintain anterior chamber depth with the posterior capsule and vitreous located posteriorly and (2) static removal of most residual lens material by viscoexpression and/or manual small incision extracapsular cataract extraction without aspiration and dynamic water flow. In 16 cases of posterior capsule rupture managed using the dry technique, the residual nucleus and cortex were readily removed with minimum extension of the ruptured area and new vitreous loss. Although large amounts of viscoelastic material (mean 5.8 mL) were required, rapid and stable visual recovery was comparable to that in patients having uneventful surgery. The dry system is a safe and reliable technique for managing posterior capsule rupture during phacoemulsification.</abstract><note>None of the authors has a financial or proprietary interest in any material or method mentioned.</note><note type="content">Figure 1: (Akura) To extract a relatively large nuclear fragment, the fragment is smoothly removed from a narrow scleral tunnel using a claw vectis because it is fixed at the claw in the tunnel. During nucleus removal, viscoelastic material is constantly injected through the vectis to maintain anterior chamber depth with the posterior capsule and vitreous located posteriorly.</note><note type="content">Figure 2A: (Akura) To isolate the epinucleus or large residual cortex from the capsule, viscoelastic material is injected into several sites between the anterior capsule and these structures. The structures are mechanically separated from the capsule by a slow stream of viscoelastic material (viscodissection).</note><note type="content">Figure 2B: (Akura) To extract a relatively small nuclear fragment, epinucleus, or large residual cortex, viscoelastic material is injected into the site below these structures and opposite the wound, producing a slow stream toward the wound. The stream leads these structures to the wound. Then, the wound is pushed down while viscoelastic material is injected to allow passage of the structures along with outflow of the viscoelastic material (viscoexpression). The viscoelastic material is used as a mechanical instrument to extract lens materials from the wound and to push the posterior capsule and vitreous downward.</note><note type="content">Figure 3: (Akura) To aspirate cortex attached to the capsule, an assistant continuously injects viscoelastic material via the corneal paracentesis according to the surgeon’s request. The cortex attached to the capsule is manually aspirated using a Simcoe cannula from 1 or 2 side-port incisions in a closed environment (dry Simcoe).</note><note type="content">Figure 4: (Akura) The extent of posterior capsule rupture in the pupil area at the time of its recognition (dotted line) and at the end of surgery (solid line) and the shape of residual nucleus at the time of capsule rupture. Vitreous was present in the anterior chamber in Case 6 and was prolapsed extraocularly in Case 10 when the capsule rupture was recognized.</note><note type="content">Table 1: Time of capsule rupture, treatment after rupture, BCVA, and postoperative complications.legend</note><relatedItem type="host"><titleInfo><title>Journal of Cataract & Refractive Surgery</title></titleInfo><titleInfo type="abbreviated"><title>JCRS</title></titleInfo><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">200107</dateIssued></originInfo><identifier type="ISSN">0886-3350</identifier><identifier type="PII">S0886-3350(00)X0027-2</identifier><part><date>200107</date><detail type="volume"><number>27</number><caption>vol.</caption></detail><detail type="issue"><number>7</number><caption>no.</caption></detail><extent unit="issue pages"><start>963</start><end>1140</end></extent><extent unit="pages"><start>982</start><end>989</end></extent></part></relatedItem><identifier type="istex">A85E9CCBF9C512398E71FC8ADC365BA4C0D8FD35</identifier><identifier type="DOI">10.1016/S0886-3350(00)00838-5</identifier><identifier type="PII">S0886-3350(00)00838-5</identifier><accessCondition type="use and reproduction" contentType="">© 2001Elsevier Science Inc.</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>Elsevier Science Inc., ©2001</recordOrigin></recordInfo></mods></metadata><enrichments><istex:catWosTEI uri="https://api.istex.fr/document/A85E9CCBF9C512398E71FC8ADC365BA4C0D8FD35/enrichments/catWos"><teiHeader><profileDesc><textClass><classCode scheme="WOS">OPHTHALMOLOGY</classCode><classCode scheme="WOS">SURGERY</classCode></textClass></profileDesc></teiHeader></istex:catWosTEI></enrichments></istex></record>Pour manipuler ce document sous Unix (Dilib)
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