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- [Show abstract] [Hide abstract] ABSTRACT: To describe the technique for the removal of bulky fibrin in persistent traumatic full hyphema by using anterior chamber maintainer (ACM). The ACM was used to reform and maintain the anterior chamber, and to flush out the clotted blood. The ACM cannula was inserted at the 6 o'clock position, and then a 2-mm-width contra lateral limbal incision was made. Slight pressure applied at the posterior lip of the incision facilitated the evacuation of the clot from the anterior chamber. Visible adherence of the clot was separated using the Sinskey hook, and firm fibrosis between fibrin and intraocular structure was cut by Vannas scissor. All liquified blood was removed through corneal incision. Any clot caught at the incision was removed by cutting the clot into smaller fragments with a Vannas scissor. ACM is a safer and affordable alternative compared to Simcoe's cannula or vitrectomy in the removal of persistent traumatic hyphema.
- [Show abstract] [Hide abstract] ABSTRACT: To assess the efficacy and safety of a modified double extra sharp chopper for removal of hard cataracts. Prospective non-comparative interventional clinical study. Forty eyes from 25 patients with hard mature cataract grades 3-4. The pre-modified Koch chopper was sharpened under the slit lamp to become extra sharp at the tip and inside the edge and 2 mm in length. Patients with hard mature cataract grades 3-4 (grade 4 being the hardest) underwent phacoemulsification by single surgery and were analyzed prospectively. The mean effective phaco time was 23.73 +/- 5.75 seconds. Minimal power was facilitated by using horizontal chopping using a self-made double extra sharp chopper. No resistance was encountered while moving the chopper, regardless of cataract persistency. Preoperative BCVA were count fingers (47%), hand movement (35%), and light perception (18%). Postoperative BCVA on day 1and day 7 were 0.57 and 0.95, respectively. There was no difference of effective phaco time among nuclear hardness (P = 0.467), which represent the effectiveness of the extra sharp chopper. The double extra sharp chopper facilitated a safe and rapid visual rehabilitation and maximal subject comfort when doing phacoemulsification for hard mature cataracts.
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