This PPT is beneficial for undergraduate Medical students

1. Dr. Atul Kumar Anand
Senior Resident
AIIMS Patna

2. Topical antibiotics: -1-3 days before
To lower iop : acetazolamide 1-2 hr before
To sustain dilated pupil :
tropicamide+phenylephrine+NSAIDS
drops

3. LA
TOPICAL
GENERAL

4. ICCE:-only indicated in subluxated &
dislocated lens
ECCE : CONVENTIONAL ,SICS ,PHACO

6. Types of IOL
PCIOL
ACIOL
Iris claw lens

7. Superior rectus bridle suture
Conjunctival flap
Partial thickness groove
Corneoscleral section
Inj. of visco in AC
Ant. Capsulotomy: can opener ,
envelope,ccc,
Enlarging of corneoscleral section
Hydrodissection : to separate cortex from
capsule

8. Removal of nucleus : pressure &
counterpressure method , iirigating wire
vectus technique
Aspiration of cortex
Inflatation of capsular bag by visco
Implantation of iol
Closure of incision
Removal of visco
Closure of conjunctival flap
subconj. inj

9. Superior rectus bridle suture
Conjunctival flap
Sclerocorneal tunnel : external scleral
incision, sclerocorneal ,int. corneal inc.
Side port entry
Ant. Capsulotomy: can opener ,
envelope,ccc,
Hydrodissection

10.  Prolapse of nucleus in AC
 Delivery of nucleus outside : irrigating wire
vectis method , blumenthal ,fishhook
 Aspiration of cortex
 Inflatation of capsular bag by visco
 Implantation of iol
 Removal of visco
 Wound closure :AC formation by hydration of
sideport
 Closure of conjunctival flap
 subconj. inj

11.  Corneoscleral incision
 ccc
 Hydrodissection & hydrodelineation
 Nucleus emulsification : divide & conquer,
phaco chop ,stop & chopAspiration of cortex
 Inflatation of capsular bag by visco
 Implantation of iol
 Removal of visco
 Wound closure :AC formation by hydration of
sideport
 Closure of conjunctival flap
 subconj. inj

12. Incision 0.9 mm
Ultra thin rollable iol
Nil astigmatism
Laser phaco

14.  Simple tech. & short learning curve
 demerits :
 Long incision
 Suture
 High risk of vit. Prolapse ,expulsive chorodial
hemmorage
 High incidence of astigmatism ,iris prolapse
wound leak , shallow AC

15. Universal : NS IV & NS V
Short learning curve
Not machine dependent
Less surgical compl. Like nucleus drop
Less operating time
Cost effective

16. Postop hyphema
Astigmatism

17. Topical
Small incision
Less corneal compl.
Less astigmatism
Quicker visual rehab.

18. Long learning curve
Complication like nucleus drop
Machine dependent
High cost
Limitations ( NS 4 & 5 )

19. Preop due to LA :
Retrobulbar hemm.
Perforation of globe
During surgery :
SR laceration
In sics : button holing , premature entry
in AC , DMD,iris injury ,pcr,vitreous loss ,
ZD,EXPULSIVE choroidal hemm. ,nucleus
drop

20. Wound leak ( siedel’s test )
Iris prolapse
Flat or shallow AC ( wound leak or CD )
Hyphema
uveitis
Endophalmitis
Pupillary block glaucoma

21. CME
RD
PCO( soemmering’s ,elschnig’s pearl)
Bullous keratopathy ( PBK or ABK )
Iol malpositioning ( sunrise & sunset
synd.),windsheild wiper synd.(iol heptic
rubs on endothelium )
UGH synd. : more in AC iol
Sec. glaucoma