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J. L. Ferreira; Phacocrush: Phacochopping at the Vitreous Cavity. Invest. Ophthalmol. Vis. Sci. 2008;49(13):6003. doi: https://doi.org/.
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A new device called phacocrush/foreign body forceps was developed to perform phacocrush: a new term for phacochopping at the vitreous cavity (crush: verb [ trans. ] press or squeeze something with force, break something hard into small pieces by pressing).
Phacocrush/foreign body forceps was developed to manipulate and crush dislocated lens or nucleus into the vitreous cavity in order to facilitate phacofragmentation or even phacoaspiration of lens material. Pars plana vitrectomy is performed using 20, 23 or 25-gauge material. A chandelier illuminator is introduced. Perfluorocarbone liquid is used to protect the macula. Lens or nucleus is hold with a soft tip canula with active aspiration. Phacocrush/foreign body forceps was developed to grasp the lens and perform phacocrush. In the adult the lens measures approximately 10 mm in diameter and is 4 mm thick, so the new forceps design had to be adapted to be able to squeeze the lens material successfully. The fragments are aspirated or removed with a 20-gauge fragmetome. In this case one of the sclerotomies was converted to 20-gauge.
In vitro technique is efficacious for phacocrush. This technique was performed with the nucleus of six patients with cataract nigra or rubra, submitted to extra-capsular cataract surgery and in two patients: one with dislocated nucleus and the other with dislocated lens at the vitreous cavity. The first patient was submitted to phacoaspiration and the second one to phacofragmentation. None of them developed adverse events, like retinal detachment.
Phacocrush is a promising new procedure to help the surgery of dislocated lens or nucleus into the vitreous cavity.
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