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Introduction Posterior polar cataracts Sporadic Inherited Bilateral Autossomal dominant

No-hydrodissection, no- hydrodelineation technique of bimanual microphacoemulsification for posterior polar cataracts Tiago Ferreira , Alberto Cardoso Centro Hospitalar de Lisboa Ocidental – Ophthalmology department , Lisbon , Portugal No financial interest. Introduction

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Introduction Posterior polar cataracts Sporadic Inherited Bilateral Autossomal dominant

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  1. No-hydrodissection, no-hydrodelineation technique of bimanual microphacoemulsification for posterior polar cataractsTiago Ferreira, Alberto Cardoso Centro Hospitalar de Lisboa Ocidental – Ophthalmology department, Lisbon, PortugalNo financial interest

  2. Introduction Posterior polar cataracts Sporadic Inherited Bilateral Autossomaldominant Cromossomes16q22, 1p36, 20p12-q12 e 11q22-q22.3 PITX3 gene – controls the development of the anterior segment of the eye Degenerative and malformedlensfibers Surroundedbyvacuoles – weakness of and adhesion to the posterior capsule No-hydrodissection, no-hydrodelineation technique of bimanual microphacoemulsification for posterior polar cataracts

  3. Posterior polar cataracts Rare, no incidence studies Population based analysis - 111 cases against 37,837 controls without ocular defects Symptoms – 3rd to 4th decade Glare, reduced visual acuity No-hydrodissection, no-hydrodelineation technique of bimanual microphacoemulsification for posterior polar cataracts

  4. No-hydrodissection, no-hydrodelineation technique of bimanual microphacoemulsification for posterior polar cataracts

  5. Surgical challenges More: zonular dehiscence Posterior capsule rupture Polar opacity  Weak, thin or absent posterior capsule Rupture – 7.1 to 36% No-hydrodissection, no-hydrodelineation technique of bimanual microphacoemulsification for posterior polar cataracts

  6. Pre-operative details  Inform the patient Possible need for further surgical interventions Possible need for Nd:YAG capsulotomy Possible amblyopia (especially in unilateral cases) No-hydrodissection, no-hydrodelineation technique of bimanual microphacoemulsification for posterior polar cataracts

  7. Techniques to avoid complications Pars plana lensectomy Slow motion phaco No-hydrodissection or hydrodissection in multiple quadrants Hydrodelineation and no nuclear rotation Viscodissection No-hydrodissection, no-hydrodelineation technique of bimanual microphacoemulsification for posterior polar cataracts

  8. Methods No-hydrodissection no-hydrodelineation technique 4 eyes of 2 patients with bilateral posterior polar cataracts Bimanual microphacoemulsification without hydrodissection or delineation Posterior capsulorhexis in 2 eyes Surgical technique – see video clip No-hydrodissection, no-hydrodelineation technique of bimanual microphacoemulsification for posterior polar cataracts

  9. No-hydrodissection, no-hydrodelineation technique of bimanual microphacoemulsification for posterior polar cataracts

  10. Results All eyes with 20/20 VA 1 case (25%) of posterior capsule rupture Sulcus-fixated IOL implanted No-hydrodissection, no-hydrodelineation technique of bimanual microphacoemulsification for posterior polar cataracts

  11. Conclusion Rare type of cataract Weak posterior capsule No-hydrodissection, no-hydrodelineation technique of bimanual microphacoemulsification Good visual results Fewer cases of posterior capsular rupture ? – more studies, with more patients needed No-hydrodissection, no-hydrodelineation technique of bimanual microphacoemulsification for posterior polar cataracts

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