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

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Phako about the Paracentesis – Advantages and Limits of the Bimanual Technique

Wilhelm F.
Dept. of Ophthalmology, Martin-Luther-University, Halle-Wittenberg

Purpose: Ultrasound phako in cataract surgery is well established. To reduce the postoperative astigmatism the size of the corneal incisions was decreased more and more. Using the conventional phako system, the limits for minimalisation of the incisions are reached .
Method: It was shown, that using separated hand pieces for irrigation and for phako-aspiration about two 1,4mm paracentesises hard nuclei could be emulsificated without any problems. Because the possibility to changes the side between the instruments the surgeon is able to work more flexible and to perform the emulsification of nuclei which are not easy to rotate. He can work extremely carefully. Especially in cases of deep eyes and with cloudy corneas and/or small pupil the system shows advantages.
Results: The clinical experiences have shown that the cartaract surgery with the bimanual system can performed without any costs for a new phako device. After only a short learning curve the phako time is only in really hard nuclei prolonged. Scanning electron microscopic examination of the corneal endothelium of pig eyes have shown that there are no increased damage. Because of the so called burning effect it was thinkable in the areas of the paracentesises after removing the sleeve during the phako procedure.
Conclusions: The advantages of the 1,0 – 1,6 mm phakoemulsifikation are especially in cases in which IOLs can be implanted about th

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