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Novel approach for phacoemulsification during combined phacovitrectomy.

Wael Ahmed Ewais1, Ashraf Abdel Maqsoud Nossair1, Lamia Samy Ali1

  • 1Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt.

Clinical Ophthalmology (Auckland, N.Z.)
|January 1, 2016
PubMed
Summary

Surgeons can safely perform phacoemulsification with a temporal clear corneal incision (TCCI) while sitting superiorly. This technique, used in combined phacovitrectomy, demonstrated good visual and anatomical outcomes without disrupting the surgical setup.

Keywords:
clear corneal incisionskeratometric astigmatismsuperior sitting positionsurgically induced astigmatismtemporal nasal horizontal superiorworking angle

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Area of Science:

  • Ophthalmology
  • Surgical Techniques

Background:

  • Combined phacovitrectomy is a common ophthalmic procedure.
  • Optimizing surgeon ergonomics during phacoemulsification is crucial for patient safety and surgical efficiency.

Purpose of the Study:

  • To assess the safety and efficacy of a superior sitting position for surgeons during temporal clear corneal incision (TCCI) phacoemulsification.
  • To evaluate outcomes in combined phacovitrectomy procedures performed with a 90° working angle from a superior sitting stance.

Main Methods:

  • A prospective interventional case series involving 65 eyes of 63 patients.
  • Phacoemulsification utilizing TCCI was performed with the surgeon in a superior sitting position relative to the operating table.

Main Results:

  • Complete phacoemulsification was achieved in all cases (100%).
  • Minimal shifts to a temporal sitting position occurred in 3% of cases.
  • Mean keratometric astigmatism and surgically induced astigmatism remained stable and within acceptable ranges at 1 and 6 months postoperatively.
  • Posterior capsule integrity was maintained in 98.5% of cases, with one rupture (1.5%).
  • Intraocular lens centration was excellent in all cases (100%).

Conclusions:

  • The superior sitting position for TCCI phacoemulsification during combined phacovitrectomy is safe and practical.
  • This technique facilitates a wide working angle without altering the surgical setup, leading to acceptable anatomical and optical results.