Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"


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Abstract
Abstract

Management of Dropped Nucleus in Modern Cataract Surgery

Gerding H.
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Münster, Germany

Nucleus or nuclear fragment dislocation is the most frequent of severe intraoperative complications in present state cataract surgery. According to available statistical data, the relative incidence of dropped nucleus increased with the establishment of phacoemulsification as the method of choice for cataract surgery. So far there are no recommendations available that can be regarded as “evidence based guidelines” for the management of this complication. On the other hand, the surgeon experiencing this complication has to decide at once for a management strategy that may bear the element of irreversibility. The coordinates of the necessary ad hoc decision has to be chosen within a complex multidimensional space of alternatives. Different strategies of dropped nucleus management will be discussed in this review on the basis of available literature and own experiences leading to a present-state guideline. The following topics will be discussed with special regard: 1. the basic intraoperative decision, 2. time of nuclear material removal, 3. technique of nuclear material removal, 4. chronically retained material, and 5. complications and long-term prognosis.


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