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Balamurali K. Ambati, Brian C. Stagg; Visco-free Phacoemulsification. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6659.
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Ophthalmic viscoelastic materials are used to protect the corneal endothelium in the overwhelming majority of cataract surgeries performed in developed countries. We hypothesized that visco-free phacoemulsification could be safely performed by using double-blade entry, visco-free capsulorrhexis, endocapsular carouseling, and hydroimplantation.
Retrospective review of five consecutive cases of visco-free cataract surgery from five patients with 2+ cataracts. Visco-free cataract surgery was performed employing double-blade entry, visco-free capsulorrhexis, endocapsular carouseling, and hydroimplantion. Outcome measures included visual acuity, corneal thickness by pachymetry, and endothelial cell density by ConfoScan4 (Nidek, Padova, Italy).
All patients demonstrated an improvement in best corrected visual acuity, with the mean best corrected visual acuity at 3 months being 20/28.There was no significant change in pachymetry from baseline during the postoperative course. There was a statistically significant decrease of 13.6% in endothelial cell density at 3 months post-op (p=0.02). This decrease in endothelial cell density is within the range reported in previous evaluations of phacoemulsification.
Our results suggest that phacoemulsification without the use of ophthalmic viscosurgical devices can be performed safely and efficiently using double-blade entry, visco-free capsulorrhexis, carouseling in the bag, and hydroimplantation. Long term follow-up and further studies are warranted.
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