Avoid rupture of the posterior capsule in cataract
Dr. DESCHATRES' method avoids the rupture of the posterior capsule and the projection of the lens into the vitreous, especially in cases of hard cataracts, thanks to two instruments: a wedge-shaped micro-manipulator and another spoon-shaped one.
Once the capsulorhexis has been performed, prolonging the hydrodissection a little will allow the lens to subluxate and assume a slightly vertical position. Then, inject viscous fluid behind the lens in order to move the posterior capsule away from it and in front of it in order to move it away from the cornea.
With the right hand, passing through the main incision, the spoon-shaped micromanipulator is slid behind the lens at its posterior pole to create counter-pressure and prevent it from moving backwards.
Using the left hand, the wedge-shaped micromanipulator is inserted through the counterpuncture hole, and from the anterior pole of the lens, the latter is pierced (stabbed) from front to back to meet the first micromanipulator placed behind the lens.
Thus, the small pressure on the lens is counterbalanced by the micromanipulator placed behind the lens.
The lens splits by itself because of its lamellar structure. There is no need to emulsify it in the usual way.
Phakic intraocular implants
These intraocular implants are called “phakic” because they are placed in the presence of the lens, unlike the implants used for cataract surgery which are intended to replace the lens that has become opaque. The procedure involves making thin incisions in the cornea through which the surgeon will insert the implant and manipulate it so that it is positioned correctly in the eye.