Before surgery protection of corneal endothelium and after

Corneal endothelium protection in phaco


Psuedophakic Bullous Keratopathy (PBL)complicated cataract surgery with inadequate management posterior cap rupture management ,or intracapsular lens implanted in the AC. PBK courts in 1 to 2% of patients in conventional surgery ,it can be 11 to 20% in eyes with endothelial count less than 1000cell / cu mm2 Risk factor for PBK , Fucks endothelial dystrophy , shallow AC,angle closure glaucoma , previous eye surgery,& very dense cataract Systemic approach for protection Recognize eye at risk — advance age ,systemic conditions,diabetes ,renal insufficiency , chronic occlusive pulmonary disease,are known to decrease endothelial cells and function Medications as amantadine for Parkonism , topical carbonic inhibitors , temsulosin increases chances of posterior cap rupture Customize the surgery be aware of surgical operations , avoid intra operative damage Increase distance from cornea , decrease amount U/S energy ,working on the iris plane holding U/S tip downwards , placing dispersing viscoelastic for every 3 to five units of cumulative energy against the endothelium create a barrier between tip and the cornea , avoiding fluid loss through paracentesis to allow deeper AC, avoid turbulence

Thank you doctor

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