Silicone Sleeve Polishing Of Posterior Capsule, A Safe And Costless I/A Technique

Abstract

 

Purpose:

 

Removing last particles of nuclear cortex from central posterior capsule is sometimes difficult. Diamond blasted cannulas or silicon tipped needles are provided as an extra material. We describe a new costless technique for capsular polish using the silicone sleeve of the Irrigation/Aspiration (I/A) cannula. It is also possible to do safer polish-aspiration of cortical masses. For surgeons who don’t use I/A cannula with silicone sleeve, using silicone sleeve on phaco tip is also possible.

 

Methods:

 

After standard I/A procedure, we unscrew a little the silicone sleeve from the metallic part of I/A cannula, just to put the sleeve a little ahead the metal cannula and recovering it. Then, we can scrap posterior capsule safely, with irrigation and none or small aspiration. For greater parts of cortex, in need of big aspiration, we unscrew the silicone sleeve and place lateral hole just in front of aspiration hole in the metallic cannula. Then we can smoothly and safely scrap the capsula adhesive cortex and just after, when a part of cortex is free, aspire it with strong vacuum.Many surgeons don’t use I/A with silicon sleeve. Nevertheless, it is possible to use the phacoemulsification handpiece. Just unscreew the silicone sleeve enough to be placed a little ahead from the phaco tip. Put the machine on I/A or Polishing position to avoid any U/S delivery. Then scrap posterior capsula or adhesive parts of cortex with irrigation and none or small aspiration. When parts of cortex are free from posterior capsule, then take I/A cannula to aspire them

 

Results:

 

We use this method for years with different types of phacoemulsification devices. It gives a very clean scraping of posterior caspsule with great safety. As far as we can know, we never find a description of similar technique in any publication.

 

Conclusions:

 

This new use of silicon sleeve is very effective and free of additional costs. Compared to specific capsule polisher cannulas, this technique offers possibility to scrap capsule and do I/A in the same time. Compared to classic polishing with metallic extremity of I/A cannula, It seems more safe to do it with a soft silicone tip.  

 

Keywords: cataract • training/teaching cataract surgery