Phacoemulsification is a cataract surgery technique introduced in 1967 involving emulsifying the lens using ultrasonic vibrations. It utilizes a small incision and irrigation/aspiration to gently break up and remove the lens, reducing postoperative complications. Key steps include incision, capsulotomy, hydroprocedures, nucleus emulsification using techniques like divide and conquer, and intraocular lens implantation. Proper fluid dynamics and pump type are important for efficient irrigation and aspiration.

1. PHACOEMULSIFICATION

2. INTRODUCTION
It was introduced by Charles Kelman in 1967.
Small Incision which in turn reduces
• Healing time
• No of sutures
• Postoperative astigmatism
• Hemorrhagic complications
Conservation of posterior chamber, avoiding retinal detachment, maintaining
vitreous.
Complete aspiration of cortex.
Easy implantation of IOL.

3. PRINCIPLES OF
PHACOEMULSIFICATION
¤Hardness of the nucleus.
¤Red reflex of the fundus.
¤Corneal transparency.
¤Trophism of iris.
¤Chamber depth.
¤Pathologies.

4. ANESTHESIA
 General Anesthesia
 Local Anesthesia
 Topical Anesthesia

5. FLUID DYNAMICS OF PHACO
►Bottle with irrigation liquid
►An irrigation tube
►The eyeball
►An aspiration tube
►An aspiration pump

6. IRRIGATION/ASPIRATION
 Irrigation depends on the height of the bottle and thus gravitational
force.
 Aspiration depends on the type of the pump
 Peristaltic.
 Venturi
 Diaphragm.

7. PERISTALTIC PUMP

8. VENTURI PUMP

9. MEMBRANE OR DIAPHRAGM PUMP

10. PARTS OF PHACOEMULSIFIER
Machine body
Connection system
Handle
•Ultrasonic probe
•I/A hand piece
•Diathermy hand piece

11. STEPS FOR PHACOEMULSIFICATION
Incision
 Limbal
 Easy to perform,
 Need sutures.
 Scleral(3.5-7mm)
 Corneal (2.8-4mm)
(4.5-6.5)

12. CAPSULOTOMY
It is the process of making the incisions around the anterior capsule of
the lens.
 Can opener.
 Christmas tree.
 Postage stamp.
 Envelope.
 Capsulorhexis.

13. CAPSULORHEXIS

14. HYDRODELINEATION
It is used to separate
epinucleus and nucleus.

15. HYDRODISSECTION
It is used to separate
capsulse and cortex ,
Cortex and epi nucleus.

16. EMULSIFICATION OF CORTEX &
NUCLEUS

17. DIVIDE AND CONQUER
Nucleus is separated into 4
pieces.
Each pieces are emulsified
separately.
Easy to do but need lots of
ultrasonic power.

18. STOP AND CHOP
Formation of groove.
Nucleus is break into two halves.
Easy to do.
Less ultrasonic power.
Need two hands.

19. IRRIGATION/ASPIRATION
The amount of irrigation flow depends on:
Diameter of the irrigating tube
Diameter of the connections
Size of the orifices in the tip
Height of the irrigating bottle
The aspiration depends on:
Diameter of the tube and orifices
Level of vacuum set on the machine
Type of pump used.

20. INTRAOCULAR LENS
Biocompatible as not to trigger any
inflammatory response.
Chemically and physically stable on the
long run.
Light weighted.
Made of PMMA.