Central cortical cleanup and zonular deficiency

Ahmad M Mansour,1,2 Rafic S Antonios,1 Iqbal Ike K Ahmed3 1Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; 2Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon; 3Department of Ophthalmology, University of Toronto, Toronto, ON, Canada Backgrou...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Mansour AM, Antonios RS, Ahmed IIK
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Brunescent cataract cortex aspiration phacoemulsification pseudo-exfoliation weak zonules. Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/507963c6fe8149e09527f45ea20a24e0
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:507963c6fe8149e09527f45ea20a24e0
record_format	dspace
spelling	oai:doaj.org-article:507963c6fe8149e09527f45ea20a24e02021-12-02T09:00:02ZCentral cortical cleanup and zonular deficiency1177-5483https://doaj.org/article/507963c6fe8149e09527f45ea20a24e02016-10-01T00:00:00Zhttps://www.dovepress.com/central-cortical-cleanup-and-zonular-deficiency-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Ahmad M Mansour,1,2 Rafic S Antonios,1 Iqbal Ike K Ahmed3 1Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; 2Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon; 3Department of Ophthalmology, University of Toronto, Toronto, ON, Canada Background: Complete removal of the cortex has been advocated to prevent posterior capsular opacification but carries the risk of zonular dehiscence, hence there is a need for a safe maximal cortical cleanup technique in eyes with severe diffuse zonulopathy in subjects above age 90. Methods: We used bimanual central cortical cleaning by elevating central fibers and aspirating them toward the periphery. Peripheral cortical fibers were removed passively only when they became loose due to copious irrigation. A one-piece foldable implant was inserted without a capsular tension ring. Postoperative corticosteroid drops were used. Results: This technique was safely performed in a dozen eyes with severe pseudo-exfoliation or brunescent cataract with weak zonules. Posterior capsular rupture, iritis, vitreous loss, and lens subluxation were not observed. Moderate capsular phimosis occurred but with maintained central vision. Conclusion: The dogma of “complete cortical cleanup” in severe zonulopathy needs to be revisited in favor of a clear visual axis with maximal preservation of the damaged zonules. This technique is ideal in patients above age 90 where posterior capsular opacification and late dislocation of intraocular lens–capsule bag complex are unlikely to occur until several years postoperatively. Keywords: brunescent cataract, cortex aspiration, phacoemulsification, pseudo-exfoliation, weak zonulesMansour AMAntonios RSAhmed IIKDove Medical PressarticleBrunescent cataractcortex aspirationphacoemulsificationpseudo-exfoliationweak zonules.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 10, Pp 1919-1923 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Brunescent cataract cortex aspiration phacoemulsification pseudo-exfoliation weak zonules. Ophthalmology RE1-994
spellingShingle	Brunescent cataract cortex aspiration phacoemulsification pseudo-exfoliation weak zonules. Ophthalmology RE1-994 Mansour AM Antonios RS Ahmed IIK Central cortical cleanup and zonular deficiency
description	Ahmad M Mansour,1,2 Rafic S Antonios,1 Iqbal Ike K Ahmed3 1Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; 2Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon; 3Department of Ophthalmology, University of Toronto, Toronto, ON, Canada Background: Complete removal of the cortex has been advocated to prevent posterior capsular opacification but carries the risk of zonular dehiscence, hence there is a need for a safe maximal cortical cleanup technique in eyes with severe diffuse zonulopathy in subjects above age 90. Methods: We used bimanual central cortical cleaning by elevating central fibers and aspirating them toward the periphery. Peripheral cortical fibers were removed passively only when they became loose due to copious irrigation. A one-piece foldable implant was inserted without a capsular tension ring. Postoperative corticosteroid drops were used. Results: This technique was safely performed in a dozen eyes with severe pseudo-exfoliation or brunescent cataract with weak zonules. Posterior capsular rupture, iritis, vitreous loss, and lens subluxation were not observed. Moderate capsular phimosis occurred but with maintained central vision. Conclusion: The dogma of “complete cortical cleanup” in severe zonulopathy needs to be revisited in favor of a clear visual axis with maximal preservation of the damaged zonules. This technique is ideal in patients above age 90 where posterior capsular opacification and late dislocation of intraocular lens–capsule bag complex are unlikely to occur until several years postoperatively. Keywords: brunescent cataract, cortex aspiration, phacoemulsification, pseudo-exfoliation, weak zonules
format	article
author	Mansour AM Antonios RS Ahmed IIK
author_facet	Mansour AM Antonios RS Ahmed IIK
author_sort	Mansour AM
title	Central cortical cleanup and zonular deficiency
title_short	Central cortical cleanup and zonular deficiency
title_full	Central cortical cleanup and zonular deficiency
title_fullStr	Central cortical cleanup and zonular deficiency
title_full_unstemmed	Central cortical cleanup and zonular deficiency
title_sort	central cortical cleanup and zonular deficiency
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/507963c6fe8149e09527f45ea20a24e0
work_keys_str_mv	AT mansouram centralcorticalcleanupandzonulardeficiency AT antoniosrs centralcorticalcleanupandzonulardeficiency AT ahmediik centralcorticalcleanupandzonulardeficiency
_version_	1718398301188915200

Central cortical cleanup and zonular deficiency

Ejemplares similares