for cataract surgery, what is used to measure predicted post-op VA?
PAM—potential acuity meter
–o-scope works too: if you can see in, pt. can see out
what are the 2 main ways of cataract surgery? old/new?
old= ICCE= intra-capsular cataract extraction
- big incision + WTR astig
- reading roblems
- major forward vitreous movement
new=extra-capsular catract extraction
-WITH PHACO= nucleus + cortex + capsule all separated, lens is emulsified and suctioned out
ECCE and phaco has on average how big of an incision? is there stiching?
without a foldable IOL= 6-7mm, WITH foldable IOL= 3-4mm
—beveled incision with no stitching
what is femtosecond laser in cataract surgery?
new fragment cataract that uses LESS E and allows for better limbal relaxing incisions
what is used near the limbus at the end of surgery to LESSEN the astig?
relaxing incision
what’s the difference between putting lens haptic (footplates) in the sulcus vs. in the capsule bag? which one’s better?
in the sulcus will tend to move and dislocate—not as good as “in the bag.”
** evaluate without pupil dilation**
capsule fibrosis–commonly posterior capsule fibrosis
epithelial cell proliferation on BOTH anterior and posterior lens capsules
** cell migration after cataract surgery 30-50$ within 1-5 yr’s post-op—esp. younger pt.
types of ultrasonic emulsification (3) are…?
- jackhammer effect due to physical needle impact on nucleus
- acoustic wave traveling in front of needle
- cavitational energy
** all cause mechanical and cavitational E and free radical generation that go past just impacting lens
what is the difference between a “square edge” and “ round edge” in cataract surgery
- square edge prevents ant. cells from traveling to the back of the capsule and causing fibrosis—but pt. has more glare–” pseduophakic edge glare
- round edge allows for fibrosis, but the optics are better
in YAG capulotomy, what % of patients develope capsule fibrosis?
30%
what does it mean to have “blended” vision for monovision IOL post op?
there is a difference of around -1.50D between the eyes
- dominant eye= plano
- other eye given -1.50D vision
what is the “floppy iris syndrome?”= IFIS
men who take prostate drugs (urinary issues)—> miosis that progresses during cataract surgery and iris prolapses into wound
what is hydro-dissection? what does it separate?
using water to separate the capsule from the cortex–> ECCE without using phaco to decrease energy on the eye
