الفهرس 
Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Phacoemulsification has become the treatment of choice for cataract
surgery over the past two decades due to Improvements in technology and
surgical techniques.
Cataract surgery using phacoemulsification techniques and
instrumentation offers a number of attractive benefits to both the surgeon and
patient. The principal advantage is a smaller incision size, which decreases the
amount of tissue injury, reduces the amount of postoperative pain and
inflammation, and provides a more rapid refractive stabilization.
In our prospective study which was conducted on 186 eyes which was that
were recruited from the outpatient clinic of Tiba ophthalmic center a written
informed consent was obtained from all patients who participated in the study.
Our study included only cataractous patients with different types of
cataract (grade I, II and III) with clear cornea and good pupillary dilatation. On
the other hand patients with tonic pupil or floppy iris or dense or traumatic or
complicated cataract or glaucomatous patient are excluded and patient with
cardiac or chest problem are also excluded.
Then we divided our patients into 2 groups: The double topical group (96
patients) and the subtenon group (90 patients). Each group underwent Cataract
surgery using phacoemulsification techniques as follows:
The pupil will be dilated as usual with tropicamide 1%, cyclopentolate
1% and phenylephrine 2.5% eye drops in both 2 groups.
Then in
The double topical group: Local anesthetic (proparacaine 0.5% drops) was
instilled in the conjunctival sac 10 minutes and 5 minutes before surgery and if
needed, during surgery.
The subtenon group: A blunt-tipped cannula is then inserted into the
posterior sub-Tenon’s space, midway between the insertions of the medial and
inferior rectus muscles. After making a small cut, the sub-Tenon’s space is
accessed using the closed blunt Westcott scissors to create a thin channel just past
the equator of the globe to the posterior sub-Tenon’s space and approximately 4
mL of local anesthetic introduced.
Then classical phacoemulsification will be carried on as usual:
Clear corneal valvular tunnel creation followed by filling the anterior
chamber with Trypan blue dye (if needed),
Then the AC was washed after half a minute with ringers lactate solution,
Then viscoelastic substance was injected to space the anterior chamber,
Then Capsulorhexis was initiated, then two side port paracentesis were done
using a 20 G MVR blade,
Then hydrodissection and hydrodelination will be done and the techniques
were used for phacoemulsification of the nucleus were divide & conquer,
stop & shop and phaco rolling,
Then Irrigation and aspiration of the cortical matter,
Summary
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Then A 6 mm optic acrylic IOL was folded and implanted in the capsular
bag,
Then wound closure was done by stromal hydration of the edges of the
corneal tunnel.
At the end of surgery after wound closure:
The double topical group: application of commercially available
moxifloxacillin (vigamox) eye drops in the conjunctival sac.
The subtenon group: A blunt-tipped cannula is then inserted into the
Subconjuctival space and the antibiotic (garamycin) is introduced.
After that a surgeon’s questionnaire for evaluating of surgical experience
during the double topical group and the subtenon group which included that:
patient comfort during surgery, difficulty during operation due to ocular motility,
anterior chamber stability, also any intraoperative complications, another
questionnaire include pain rating scale for patient evaluation of pain during
surgery during both groups.