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Corticocapsular adhesions and their effect during cataract surgery
Abhay R Vasavada1, Deepa Goyal, Lajja Shastri
1Iladevi Cataract & IOL Research Centre, Ahmedabad, India. shail@ad1.vsnl.net.in
Journal of Cataract and Refractive Surgery
|March 22, 2003
Summary
Corticocapsular adhesions in cataract surgery, particularly equatorial types, often hinder nucleus rotation. Preoperative evaluation and specialized hydrodissection techniques are crucial for managing these challenging adhesions.
Area of Science:
- Ophthalmology
- Surgical Techniques
Background:
- Cataract surgery involves managing various intraoperative challenges.
- Corticocapsular adhesions can complicate phacoemulsification, affecting nucleus manipulation.
Purpose of the Study:
- To classify corticocapsular adhesions based on preoperative appearance.
- To assess the surgical difficulties posed by these adhesions during cataract surgery.
Main Methods:
- Prospective study of 76 eyes with senile cataract and suspected corticocapsular adhesions.
- Preoperative slitlamp examination to identify adhesion types.
- Intraoperative grading of nucleus rotation difficulty after hydrodissection.
Main Results:
- Corticocapsular adhesions confirmed in 86.84% of cases.
- Equatorial adhesions were most common (94.74%), followed by posterior (56.26%) and anterior (52.74%).
- Nucleus rotation was impossible in 47.37% and difficult in 39.47% of eyes.
Conclusions:
- Thorough preoperative assessment, including slitlamp examination with extreme gaze and pupil dilation, is recommended.
- Equatorial corticocapsular adhesions significantly impede nucleus rotation.
- Multiquadrant and focal cortical-cleaving hydrodissection aids in separating adhesions and facilitating nucleus rotation.