Calculation of tunnel incision parameters during phacoemulsification in patients with previous anterior radial keratotomy

Authors

  • S.I. Kosuba Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine, Ukraine
  • О.V. Petrenko Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine, Ukraine
  • O.V. Tumanova Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine, Ukraine
  • O.V. Wojciechowski Kyiv City Clinical Ophthalmological Hospital “Eye Microsurgery Center”, Kyiv, Ukraine, Ukraine

DOI:

https://doi.org/10.22141/2309-8147.9.3.2021.247908

Keywords:

cataract, phacoemulsification, anterior radial kerato­tomy

Abstract

Background. The purpose was the choice of the type of tunnel incision on the basis of mathematical calculations in cataract patients with a previous anterior radial keratotomy. Materials and methods. During the calculations, the formula for the chord length of a circle was used: L = 2R · sin(α/2), where R is the radius of the cornea, α is the angle (in degrees) between the two corneal incisions. The chord length was measured on the limbus (upper edge of the tunnel incision) and 2 mm from the limbus (lower edge of the tunnel incision). The chord 2 mm from the limbus is more important because the distance between kerato­tomy incisions at this site is smaller. From 0.4 to 1.0 mm must be added to the width of the knife blade, depending on the type of postoperative corneal healing, which will be the key to crossing the incisions. Results. The most common knives are those 2.2 mm long with a tunnel length of 2 mm. Therefore, we perform calculations based on this knife in patients with 8 and 12 keratotomy incisions and a corneal diameter of 12 mm vertically and 11 mm horizontally. In patients with 8 keratotomy incisions, a 2.2 mm knife can be used for a corneal tunnel incision, and in patients with 16 incisions, it is impossible to use a corneal tunnel. Conclusions. In cataract patients who have previously undergone anterior radial keratotomy, a special approach is needed to the choice of tunnel incision. The choice of access depends on the diameter of the cornea, the number of keratotomy incisions and the width of the knife and is calculated using the formula for the chord length of a circle.

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Published

2021-12-29

Issue

Vol. 9 No. 3 (2021)

Section

Ophthalmosurgery

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