A new technique of cataract surgery via two microincisions of 1.5 mm and a phacotip without silicone sleeve is described in this paper. The irrigation is performed via a service incision (port) with a supporting device of the diameter of 20 G. Main problems of this method are discussed: the risk of the wound burns, and the insufficient stability of the anterior chamber. Based on author's own experience from 80 operations performed, and on the data in the literature, the suggestions how to perform this surgery safely using the conventional phaco machine are outlined. The author uses microtip--micro Kelman, pulse mode 5-10 pulses/sec, flow ratio about 20 mL/min, vacuum up to 200 mm Hg, an overpressure cuff to increase the irrigation volume, and a thin walled supporting irrigation device of the inner diameter of 0.7 mm minimum. In the conclusion, it is discussed, if this may be regarded as a progressive method and if it will be widely used. A precondition for its extended use is the wider commercial offer of intraocular lenses, which could be easily implanted trough the micro-incision just described.

Ocní oddĕlení Klaudiánovy nemocnice Mladá Boleslav