Phacoemulsification with vitreous loss using phacoemulsifier and vitrector concurrently: bimanual-bipedal technique

Area of Science:

• Ophthalmology
• Surgical Techniques

Background:

• Vitreous loss is a known complication during phacoemulsification.
• Current guidelines recommend ceasing the procedure and careful probe withdrawal to minimize vitreous traction.

Purpose of the Study:

• To introduce and evaluate a novel bimanual-bipedal technique for managing vitreous loss during phacoemulsification.
• To enhance safety and efficiency in cataract surgery when vitreous loss occurs.

Main Methods:

• The bimanual-bipedal technique involves stabilizing the phacoemulsification probe.
• A vitrectomy cutter is inserted through a pars plana port to remove vitreous around the phacoemulsification tip.
• The vitrectomy cutter is then used to retain lens fragments while phacoemulsification resumes.

Main Results:

• The technique allows for the vitrectomy cutter to act as a retainer for lens fragments, similar to a bimanual hook.
• Synergistic aspiration between the vitrectomy cutter and phacoemulsification probe prevents fragment displacement.
• This approach facilitates continued phacoemulsification with improved fragment control.

Conclusions:

• The bimanual-bipedal technique presents a potentially more streamlined and safer method for managing phacoemulsification with vitreous loss.
• This innovative approach may improve outcomes in complex cataract surgeries.