Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: * La phaco-émulsification ds le syndrome PEC est une chirurgie à risque liée :
a la mauvaise dilatation et a la fragilité zonulaire +++
- Certaines règles chirurgicales permettent d’ éviter bcp de ses complications et mener une chirurgie sure
* Introduction:
- Micro-fibrillopathie d’origine inconnue , lié à l’age (prévalence augmente après 60 ans )
- Production + dépôt matériel fibrillaire dans Segment Antérieur
* Modification de tous tissus oculaires : - Mauvaise dilatation - Fragilité zonulaire - Rupture barrière hémato-aqueuse - Phacodonésis - sub-luxation cristallin - Atteinte endothéliale - 25% des cas ass Glaucome angle ouvert
*Complications chir spécifiques :
- Désinsertion zonulaire +++ (avec cps redoutable = le noyau ds le vitré )
- Décompensation cornéo-endothéliale
- Inflammation post-op
- pic tentionnel post-op
- Sub-luxation de l’implant ds la chambre postérieure
*Avant chirurgie : des précautions à prendre :
- Ex de tous patients après dilatation irienne (recherche matériel
pseudo-exf sur cap ant)
- Recherche HTO
- Recherche Phacodonésis ++++++
* La chirurgie, un seul but : Ayez pitié de la zonule
- Baisser la potence
- Baisser le tonus en retirant du VE avant l’hydrodissection
- Hydrodissection douce ++
- Technique chirurgicale surtout le chop : en réduisant les
manœuvres sur le noyau + en diminuant le stress zonulaire
en évitant tractions périphériques
- Une bonne alternative : anneaux de tension zonulaire ou capsulaire (protection de la zonule pendant toutes étapes de la phaco)
* Quelles décisions chirurgicales ?
-Choisir :
. cataractes plus jeunes , de Grade 1 a 3
. bonnes dilatations
. absence HTO
- Faire Attention :
. cataractes dures +
. mauvaises dilatations
. Age avancé ++
- Phacoémulsifiassions Risquée - changer de technique :
. Phacodonesis +++
* conclution:
- La phaco-émulsification ds le syndrome PEC est une chirurgie à risque liée : a la mauvaise dilatation et a la fragilité zonulaire +++
- C’est une chirurgie différente + stressante
-Un prince : C’est d’operer précocement ces cristallins fragiles +++

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability