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'Immobile movement' enhances safety of bimanual microincision cataract surgery
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PARIS — The new "immobile movement" technique for small-incision bimanual cataract surgery makes the procedure safer, avoiding the often-undetected trauma to the ciliary processes and repercussion on the blood-ocular barrier, according to two surgeons speaking at the meeting of the French Society of Ophthalmology.
"Damage to the ciliary processes is masked by the iris during surgery," said Philippe Sourdille, MD. "However, with the help of Miyake-Apple views, we found that elongation of the ciliary processes, and therefore rupture of the ocular barriers, is caused by surgical maneuvers like capsulorrhexis, nucleus fragmentation, nucleus removal and IOL implantation."
This damage can lead to transient complications or more severe consequences such as cystoid macular edema and retinal detachment.
"Our technique eliminates the risk of these complications entirely," Dr. Sourdille said.
"Immobile movement" means that all the maneuvers are carried out in the middle of the capsular bag, without moving the periphery, to avoid traction on the ciliary processes.
"The capsulorrhexis is performed smoothly, without creating folds to avoid zonular traction, and hydrodissection is carried out without rotating the nucleus to avoid traction on the ciliary processes," Christophe Poirier, MD, said. "During bimanual nucleus fragmentation, we pay a lot of attention to gently separate the fragments without moving the periphery of the capsular bag. For IOL implantation, we place the injector in the center of the capsular bag to have symmetrical, simultaneous unfolding of the haptics in the capsular bag, thus avoiding asymmetrical tractions of the capsular bag."