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Extra info for Masters Guide to Manual Small Incision
This can result in an iridodialysis. This has occurred to me 3 times out of approximately 10,000 cases. Just be aware this can happen, and it will not happen to you. As with any surgical procedure, this procedure is more easily learned by watching video tape than with a written description. This procedure was shown on Bobby Osher’s Video Journal of Cataract and Refractive Surgery Vol IV, Issue 1, 1988, and on the Video Journal of Ophthalmology, Vol IV, Number 4, 1988. It is also in the ASCRS Film Festival Library 1987 and 1991, and in the ESCRS Video Library, 1999.
I think you will be impressed by the ease and safety of this pupil stretching maneuver, and by the relatively normal appearance of the pupil postoperation. ANTERIOR CAPSULOTOMY Any type of capsulotomy works well with this procedure. I prefer a capsulorhexis. The capsulorhexis, however, needs to be made as large as possible to allow nucleus tip-up. A can-opener capsulotomy works well also and is used if there is difficulty with the capsulorhexis. 14A to D). I prefer a Gimbel Utrata forceps for the capsulorhexis.
The internal flap is sealed by pressurizing the eye with BSS through the side-port. Blood in the wound gives a Seidel effect to demonstrate any leak. The chamber depth can also be observed to demonstrate no leak. If the chamber deepens with pressurization and does not shallow once the pressurization cannula is removed, self-sealing is indicated. 39). 40). CAVEATS This technique is viscoelastic dependent. Be sure to have plenty of viscoelastic both in front of the nucleus and behind it when sandwiching.