Chemical composition of red mud (%).
\r\n\tThe contents of the book will be written by multiple authors and edited by experts in the field.
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Manning is a Principal Scientist (Rank Grade 9) in the Coasts & Oceans Group at HR Wallingford (UK) and has over 23 years of scientific research experience (in both industry and academia) examining natural turbulent flow dynamics, fine-grained sediment transport processes, and assessing how these interact, (including both field studies and controlled laboratory flume simulations). Andrew also lectures in Coastal & Shelf Physical Oceanography at the University of Plymouth (UK). Internationally, Andrew has been appointed Visiting Professor at four Universities (Hull, UK; Delaware, USA; Florida, USA; Stanford, USA), and is a highly published and world-renowned scientist in the field of depositional sedimentary flocculation processes. Andrew has contributed to more than 90 peer-reviewed publications in marine science, of which more than 50 have been published in international scientific journals, plus over 140 articles in refereed international conference proceedings, and currently has an H-index of 23. He supervises graduates, postgraduates and doctoral students focusing on a range of research topics in marine science. Andrew has led numerous research projects investigating sediment dynamics in aquatic environments around the world with locations including: estuaries, tidal lagoons, river deltas, salt marshes, intertidal, coastal waters, and shelf seas.",institutionString:"HR Wallingford",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"HR Wallingford",institutionURL:null,country:{name:"United Kingdom"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"10",title:"Earth and Planetary Sciences",slug:"earth-and-planetary-sciences"}],chapters:[{id:"67398",title:"Pollution Issues in Coastal Lagoons in the Gulf of Mexico",slug:"pollution-issues-in-coastal-lagoons-in-the-gulf-of-mexico",totalDownloads:115,totalCrossrefCites:0,authors:[null]},{id:"68934",title:"Environmental Monitoring of Water Quality as a Planning and Management Tool: A Case Study of the Rodrigo de Freitas Lagoon, Rio de Janeiro, Brazil",slug:"environmental-monitoring-of-water-quality-as-a-planning-and-management-tool-a-case-study-of-the-rodr",totalDownloads:58,totalCrossrefCites:0,authors:[null]},{id:"67761",title:"A GIS-Based Approach for Determining Potential Runoff Coefficient and Runoff Depth for the Indian River Lagoon, Florida, USA",slug:"a-gis-based-approach-for-determining-potential-runoff-coefficient-and-runoff-depth-for-the-indian-ri",totalDownloads:183,totalCrossrefCites:0,authors:[null]},{id:"68510",title:"Hypersaline Lagoons from Chile, the Southern Edge of the World",slug:"hypersaline-lagoons-from-chile-the-southern-edge-of-the-world",totalDownloads:57,totalCrossrefCites:0,authors:[null]},{id:"69785",title:"Process-Based Statistical Models Predict Dynamic Estuarine Salinity",slug:"process-based-statistical-models-predict-dynamic-estuarine-salinity",totalDownloads:16,totalCrossrefCites:0,authors:[null]},{id:"68885",title:"Lagoons Reefs of Alacranes Reef and Chinchorro Bank: Ocean Reef of Mexican Atlantic",slug:"lagoons-reefs-of-alacranes-reef-and-chinchorro-bank-ocean-reef-of-mexican-atlantic",totalDownloads:32,totalCrossrefCites:0,authors:[null]},{id:"68286",title:"Subtropical Coastal Lagoon from Southern Brazil: Environmental Conditions and Phytobenthic Community Structure",slug:"subtropical-coastal-lagoon-from-southern-brazil-environmental-conditions-and-phytobenthic-community-",totalDownloads:76,totalCrossrefCites:0,authors:[null]}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"286446",firstName:"Sara",lastName:"Bacvarova",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/286446/images/8491_n.jpg",email:"sara.b@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. 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The exit of red mud fluctuates, depending on the structure and properties of processed bauxite raw materials, within 0.8–1.2 kg per tonne of aluminium. In the world, more than 50 million tonnes of red mud are dumped in dumps or reservoirs each year.
In 60 years of operation of the aluminous shop of the Ural Aluminium Plant, three mud storage facilities have been constructed using more than 500 hectares of area with over 63 million tonnes of red mud. A similar picture is seen with the Bogoslovsk Aluminium Plant: mud storage facilities occupy a space of more than 400 hectares with more than 40 million tonnes of mud.
Currently, about 600 million tonnes of red mud are saved in Russia, and this quantity increases annually by 5–8 million tonnes. In the Sverdlovsk region, mud storage facilities managing more than 137 million tonnes are necessary, and 3 million tonnes of dangerous waste are formed every year.
Negative environmental impact has proven the urgency of the problem of red mud usage. Moreover, there are useful components within the contents of red mud at the industrial level that increase prospects of its utilisation. However, the existence and influence of other red mud components that may variously impact technological processes in the blast furnace, structure and properties of products from blast furnace smelting still require detailed study.
In works [1, 2] the technological expediency of using red mud as a ferriferous additive in blast furnace smelting has been shown. However, excepting the iron generally provided in the form of Fe2O3, which contains 15–20% А12O3, the ratio of CaO/SiO2 is close to one, which contains to 4–5% of MgO. Existence of such a quantity and a combination of slag-forming components allows red mud to be used as an additive to correct properties of final slags on physical and chemical properties.
In work [3] it is noted that the iron oxide accounts for about 50 wt% in the red mud; therefore, it is logical to consider the possibilities of red mud usage in burden structure for receiving blast furnace agglomerates. However, it is also necessary to consider that this material considerably concedes to processed iron ores according to the content of iron. Its application undoubtedly reduces productivity of blast furnaces and increases coke consumption. The specified minus is blocked by pluses from essential increases in the durability of the agglomerate. Red mud is found to prevent polymorphism of two-calcium silicate in the structure of the agglomerate. It also leads to the elimination of internal tension destroying the agglomerate. A reduction of the fraction of 0–5 mm per 1% promotes a gain of productivity of the blast furnace per 1% with the same economy of consumption as the expensive blast furnace coke. The binding properties of red mud are also revealed. The burden pelletising and its gas permeability improve. Productivity of sintering machines raises by 5–10% without capital expenditure. If the guantity of small fraction in the agglomerate is reduced by 3–5%, and reduction in the content of iron averages about 0.5%, the summary of technological efficiency in blast furnace production has a gain of 1.2–2.5% on production of cast iron and 1.5–1.8% on economy of blast furnace coke. In addition, the red mud input in the structure burden agglomerate will form a hardened aluminoferrite ligament of agglomerate and pellets. The exit of 0–0.5 mm during the heating and reduction of the agglomerate and pellets in blast furnaces is reduced by 20–40%. Therefore, iron losses with dust taken out from blast furnaces decrease and productivity grows.
In work [4] a negative factor of the ecology of the Russian blast furnace production is noted: the environmental harm from large dust output caused by low mechanical strength and durability in the reduction of blast furnace agglomerates and pellets. This shortcoming can be eliminated through the initial burden of the waste of aluminous production—red mud. Still, it can be hampered by the negative consequences of a reduction in the content of iron in blast furnace burdens. Calculations prove that the negative effect is compensated for by a reduction in the number of small-sized fractions in blast furnace burdens. Domestic agglomerates have been chosen for an assessment of the influence of additive red mud on the increase in productivity and reduction of coke consumption: Bakal with minimum 43.8%, Kachkanar with maximum 60.0% iron content and the Magnitogorsk agglomerate with an average iron content of 53.10%. Calculations establish an introduction in agglomerate burdens of 2% red mud (with mass percentages: 30.0–50.0 Fe2О3, 12.0–15.0 Al2О3, 4.0–7.0 SiO2, 5.0–8.0 CaO, 4.0–5.0 ТiO2, 2.0–4.0 Na2O, 2–3 others, 8–10 losses on calcination), taking into account the reduction of the content of a trifle that allows an increase in the productivity of blast furnaces in the range of 0.67–3.67%, with economy of 0.23–1.73% coke. What’s more, inputting red mud in the structure of the blast furnace burden allows additional technological effects at the expense of education protective scar in a high-temperature zone of blast furnace lining with the raised content in blast furnace slag of hard titanium dioxide.
Work [5] notes a thermal agglomeration of ores and concentrates on the removal of harmful impurities of sulphur and phosphorus. It is useful that red mud is used for the improvement of the quality of iron ore agglomerates and pellets. In this work, it is established that in the agglomeration of red mud in aluminous production, it is possible to delete not less than 45% of alkalis and 65% of sulphur from the mud at an optimum consumption of solid fuel; additionally, by the oxidation-reduction roasting of pellets from red mud, it is possible to reduce the content of alkali, sulphur and phosphorus, respectively, by 58–60%, 31–38% and 10–15%. Sintering and roasting are carried out in semi-factory bowls with a 420 mm diameter, while the oxidising roasting of pellets from red mud is carried out at 1000–1200°C and reduction roasting at 1100–1200°C. Coke is used as a reducing agent at a coarseness of <1 mm, which was loaded into a crucible together with pellets in a mass ratio of 1:1 that provided protection of pellets against oxidation. After oxidising and reduction, roasting pellets were exposed to phase and chemical analysis.
Work [6] performs the development of technology for the Ural Aluminium Plant’s red mud enrichment by receiving an iron concentrate of FeO = 45–50%. The structure of red mud minerals was defined when studying a polished section under a microscope using the programme “the Mineral-7”. The Ural Aluminium Plant red mud enrichment methods are mainly the magnetic and gravitational methods, as well as the physical and chemical methods; a product attrition in the rotor-pulsating device with participation of processes of cavitation from surface processing by hexametaphosphate for a flocculus dispersion has been chosen. It is revealed that the general mineral content of iron in studied tests of the Ural Aluminium Plant makes 53 and 15% from chamosite with an iron content making 18%. In the structure of red mud, there is a significant amount of amorphous formations (flocculus) in which grains of iron-bearing minerals are included. The study of material structure has revealed the following directions for red mud enrichment: attrition; use of dispergators and rotor-pulsating units for flocculus disaggregation of initial red mud; high-gradient magnetic separation for separation of haematite, chamosite and goethite; and gravitational enrichment on a concentration table for operational development of magnetic products.
The results of research on properties of the monomineral fractions allocated from red mud are given in work [7]. The main fractions of red mud are haematite, chamosite and calcite. These fractions have been received by enrichment methods. At monomineral fractions the material structure and physical characteristics (signs), such as a specific magnetic susceptibility and true density, have been defined, and the factor of visibility between separate fractions on each of the physical signs is calculated. The maximum values of factors of visibility 3.75 and 2.3 on a specific magnetic susceptibility have been received, respectively, between haematite and calcite and haematite and chamosite. It has allowed the prediction of the first operations of the technological scheme of enrichment and the main and recleaning high-gradient magnetic separation with an induction of a magnetic field of 1.4–1.5 Tesla, which have been received when studying the dependence of specific magnetic moments of monomineral fractions from the set induction of a field. Further operations of the scheme (gravitational) have been predicted on the basis of the analysis of fraction visibility factors and checked with the use of a concentration table and Knelson separator. The results of research studies issue the optimum technological scheme of red mud enrichment as receiving an iron concentrate with a 50% general iron content and a 15% output.
Work [8] shows that the additive-enriched red mud in quantities of 4% in the high-basicity agglomerate burden of Kachkanarsky Mining and Processing Integrated Works leads to growth in the quality of the agglomerate and slightly influences indicators of blast furnace smelting; this means that enriching red mud additives in agglomerative production with subsequent blast furnace repartition is a perspective technology for their utilisation. As a positive influence of red mud additives to agglomerates, the increase in the content of MgO in the final slags with 9.1 to 11.2–11.5% is noted as a slight improvement to the negative influence of mud on properties of slags. The increase of magnesia in the final slags, especially when processing high-fluxed agglomerates, leads to increased stability in their phase structure, particularly regarding areas on the border of melilite and spinel slags displaced towards pure spinel, i.e. in areas of more stable temperatures in the beginning of crystallisation. Influence of the specified factor has allowed properties of slag to be saved at the required level—despite an increase in the content of alumina in slag—and has weakened influence of red mud on its properties.
Work [9] studies the structure, thermal characteristics and composition of red mud in the current production of the Ural Aluminium Plant with the help of spectral methods (a mass fraction on solids: 46.7% Fe2О3, 12.8% Al2О3, 14.5% SiO2, 10.85% СаО, 4.7% ТiO2, 4.7% Na2O, 1.125% others). X-ray analysis is carried out on a diffractometer by X’Pert PRO (PANanalitical, the Netherlands) in monochromatic CuKa radiation. For the purpose of specification of the search for iron atoms in different minerals, samples of red mud have been investigated by a method of Mössbauer spectroscopy. In work MS-1104Em, a spectrometer with a source of Co57 in a rhodium matrix was used. The isomerous shift was relatively defined α-Fe. For high-quality determination of the sizes of mineral phases and distribution of elements in them, the samples of red mud have been studied on the electron microscope JXA-8100 (JEOL, Japan) with a power dispersive system, INCA Energy 400. Extant research of red mud structures shows that from the point of view of iron ore materials, the material represents a difficult system of dispersed and ultradispersed crystals of haematite surrounded by ferriferous phases in the form of a crystal phase of chamosite and amorphous iron-silica-alumina phases. Enrichment of such material through traditional means is represented as difficult to realise.
Work [10] establishes the basis of studying red mud structures in the current production of the Ural Aluminium Plant subject to reduction roasting and attempts to define the expediency of magnetic separation of roasting production on the basis of the results of complex research. For this purpose, briquetted samples of red mud in the current production of the Ural Aluminium Plant are subjected to roasting in a weak reduction environment (a gas mix CO2 (95%) and Н2 (5%)) and the reduction environment (Н2 (100%)) at 810°C. The completed research study on red mud structure after heat treatment in reduction environments and analysis of similar research has shown that achieving effective magnetic separation will only be possible under conditions that develop physical and chemical impacts on the growth of crystals in the magnetic phases, which form during reduction roasting within the range of 800–1000°C.
The existence of alkalis in red mud represents danger for the technological process of agglomeration, especially for blast furnace smelting technology as it has harmful effects on the flameproof lining of the blast furnace.
In 2011, experts from the United Company RUSAL, together with scientists from “Uralpromenergoproyekt”, Institute of Solid State Chemistry of the Ural Branch of the Russian Academy of Sciences, Institute of Metallurgy of the Ural Branch of the Russian Academy of Sciences and the Moscow Institute of Steel and Alloys, have carried out a number of research projects on red mud and its properties with the aim of creating technology for its complex processing, including projects on dealkalisation, dehydration, enrichment and extraction of rare earth metals. Results of research studies are based on the creation of trial experimental industrial plants for red mud processing by calculating the productivity of 200,000 tonnes of mud in a year at the Ural Aluminium Plant.
The chemical composition of red mud in the current production of the Ural Aluminium Plant is given in Table 1 (Mud 1), and alkaline-free red mud is listed after the above-stated plant (Mud 2).
No. | Fe | FeO | CaO | MgO | SiO2 | TiO2 | Al2O3 | MnO | P2O5 | SO3 | R2O | LC* |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Mud 1 | 28.36 | 5.88 | 21.32 | 0.63 | 9.24 | 4.14 | 12.35 | 0.30 | 0.60 | 0.90 | 0.76 | 10.30 |
Mud 2 | 27.80 | 5.79 | 20.9 | 0.8 | 9.85 | 4.06 | 11.9 | 0.35 | 0.31 | 0.36 | — | 11.00 |
Chemical composition of red mud (%).
LC—Losses on calcination.
Sintering was carried out on the agglomerative cap of a 320 mm diameter, established in the JSC Uralmekhanobr laboratory. The structure of alkaline-free red mud is given in Table 2.
Material | Weight fraction (%) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Fe | FeO | SiO2 | CaO | MgO | Al2O3 | P | S | C | LC | |
Iron ore concentrate | 62.1 | 28.1 | 3.6 | 1.06 | 2.06 | 2.44 | <0.01 | 0.025 | — | 2.33 |
Limestone | — | — | 1.39 | 53.2 | 0.32 | 0.71 | — | — | — | 42.4 |
Coke | — | — | — | — | — | — | — | 0.54 | 83.8 | 83.8 |
Ash of coke | 6.13 | 1.08 | 48.0 | 8.02 | 1.96 | 24.4 | 0.32 | 1.34 | — | — |
Chemical composition of components of agglomerative burden.
The structure of agglomerative burden for the agglomerative factory of JSC Kachkanarsky Mining and Processing Integrated Works is given in Table 2 (LC—losses on calcination).
After carrying out sintering-ready agglomerate three times, dumped from a height of 3 m according to GOST 25471-82, granulometric composition of the received agglomerate was defined, an output of suitable, drum-type durability and an abradability in accordance with GOST 15137-77. Agglomerate sampling for all types of tests was carried out in accordance with GOST 26136-84. The metallurgical properties of agglomerate, reducibility and a durability indicator at reduction were defined in accordance with GOST 19575-84. Results of tests are given in Tables 3 and 4.
No. | Indicator/red mud (%) | 0 | 1 | 2 | 3 |
---|---|---|---|---|---|
1 | Durability (%) | 68.73 | 72.93 | 67.07 | 67.73 |
2 | Abrasiveness (%) | 7.13 | 6.07 | 11.00 | 8.27 |
3 | Specific capacity (t/(m2 hour)) | 1.13 | 1.07 | 0.65 | 0.86 |
4 | Output of suitable (%) | 76.83 | 71.32 | 64.08 | 69.68 |
Results of tests on agglomerate sintering with additives of red mud (%).
Content of red mud (%) | GOST 15137-77 | GOST 17212-84 | GOST 19575-84 | GOST 26517-85 | |
---|---|---|---|---|---|
Durability (+5 mm, %) | Abradability (−0.5 mm, %) | Reducibility (%) | Durability by Linder | Temperature range (°C) | |
0 | 68.7 | 7.1 | 65.2 | 36.5 | 1153–1266 |
1 | 72.9 | 6.1 | 73.7 | 27.4 | 1178–1334 |
2 | 67.1 | 11.0 | 69.6 | 31.5 | 1169–1313 |
3 | 67.7 | 8.27 | 69.0 | 32.1 | 1168–1309 |
Metallurgical properties of iron ore agglomerate when using red mud.
For production pellets, Kachkanarsky Mining and Processing Integrated Works concentrates are bentonite and red mud. The chemical composition of materials is shown in Table 5 (LC—losses on calcination). The content of particles of class in concentrate makes less than 0.071 mm—90 and 100% in bentonite and red mud.
Material/element | Fe | FeO | Fe2O3 | SiO2 | CaO | MgO |
---|---|---|---|---|---|---|
Kachkanarsky concentrate | 61.9 | 28.3 | 57.0 | 3.93 | 1.10 | 2.68 |
Bentonite | 3.6 | 1.3 | 3.7 | 58.5 | 2.43 | 2.86 |
Red mud | 27.7 | 5.79 | 33.14 | 7.24 | 19.9 | 0.74 |
Material/element | Al2O3 | TiO2 | S | LC | ∑ | |
Kachkanarsky concentrate | 2.19 | 2.75 | — | 1.0 | 98.95 | |
Bentonite | 18.3 | — | — | 5.0 | 92.09 | |
Red mud | 12.8 | — | 0.36 | 11.1 | 91.07 |
Chemical composition of burden components for receiving pellets with different contents of red mud (%).
Heat treatment of dry pellets was carried out in the vertical tubular furnace with height of isothermal zone (100–120 mm). Characteristics of the crude and burned pellets are shown in Tables 6–8 (1—pellets with 0.7% of bentonite, 2—pellets with 0.7% of bentonite and 2% red mud, 3—pellets with 0.7% of bentonite and 4 mass % red mud, and 4—pellets with 0.7 mass % of bentonite and 6 mass % red mud).
No. of test | Binding additives | Properties of pellets | |||||
---|---|---|---|---|---|---|---|
Bentonite (%) | Red mud (%) | Damp pellets | Pressure (kg/dry pellet) | ||||
Moisture (%) | Pressure (kg/pellet) | Dropping (3 m, times) | Dropping (1 m, times) | ||||
1 | 0.7 | — | 6.87 | 1.15 | 4.0 | 1.0 | 2.81 |
2 | 0.7 | 2.0 | 7.0 | 1.25 | 4.2 | 1.0 | 2.06 |
3 | 0.7 | 4.0 | 6.85 | 1.15 | 4.5 | 1.0 | 1.84 |
4 | 0.7 | 6.0 | 7.0 | 1.36 | 4.5 | 1.0 | 1.72 |
5 | — | 2.0 | 6.34 | 1.13 | 2.9 | 0 | 0.57 |
6 | — | 6.0 | 6.9 | 1.31 | 3.6 | 1.0 | 1.0 |
7 | 0.35 | 6.0 | 7.0 | 1.32 | 3.9 | 1.0 | 1.55 |
8 | 1.0 | 6.0 | 7.0 | 1.88 | 7.4 | 1.0 | 3.45 |
Strengthening characteristics of nonfluxed pellets with different contents of binding additives in the form of bentonite and red mud.
No. | Heat treatment conditions | Durability of burned pellets (kg/pellet) | FeO (%) | |||
---|---|---|---|---|---|---|
Part of layer | Time lag at 1050°C (minutes) | Roast | ||||
t (°C) | τ (minutes) | |||||
1 | Top | 5 | 1300 | 6 | 325 | 4.17 |
Middle | 3 | 1270 | 3 | 317 | 2.92 | |
Bottom | — | 1230 | 1 | 260 | 1.64 | |
Average | — | — | — | 301 | 2.91 | |
2 | Top | 5 | 1300 | 6 | 334 | 3.62 |
Middle | 3 | 1270 | 3 | 365 | 2.83 | |
Bottom | — | 1230 | 1 | 330 | 1.89 | |
Average | — | — | — | 343 | 2.78 | |
3 | Top | 5 | 1300 | 6 | 300 | 3.85 |
Middle | 3 | 1270 | 3 | 376 | 2.2 | |
Bottom | — | 1230 | 1 | 308 | 1.53 | |
Average | — | — | — | 328 | 2.52 | |
4 | Top | 5 | 1300 | 6 | 317 | 3.3 |
Middle | 3 | 1270 | 3 | 303 | 1.93 | |
Bottom | — | 1230 | 1 | 306 | 1.22 | |
Average | — | — | — | 309 | 2.15 |
Heat treatment conditions on air of nonfluxed pellets with additives of red mud, their strengthening characteristics and chemical composition.
No. | Binding additives | Properties of pellets | ||||||
---|---|---|---|---|---|---|---|---|
Bentonite (%) | Red mud (%) | Damp pellets | Pressure (kg/dry pellet) | Pressure (kg/roasting pellet) | ||||
Moisture (%) | Pressure (kg/pellet) | Dropping (3 m, times) | Dropping (1 m, times) | |||||
1 | 0.7 | — | 6.70 | 1.15 | 4.0 | 1.0 | 2.26 | 301 |
2 | 0.7 | 2.0 | 6.75 | 1.15 | 4.2 | 1.0 | 2.06 | 343 |
3 | 0.7 | 4.0 | 6.73 | 1.10 | 4.5 | 1.0 | 1.74 | 328 |
4 | 0.7 | 6.0 | 6.70 | 1.10 | 4.6 | 1.0 | 1.72 | 309 |
Metallurgical properties of iron ore pellets when using alkaline-free red mud.
Trial tests of production of agglomerate were carried out in the conditions of JSC Kachkanarsky Mining and Processing Integrated Works. Results are shown inTable 9.
Experience condition/burden | Base | Fe 53.3% (basicity 2.1) | Fe 54.0% (basicity 1.9) | Fe 54.0% (basicity 1.8) |
---|---|---|---|---|
Concentrate (kg) | 15.0 | 15.0 | 15.00 | 15.00 |
Red mud (kg) | — | 1.10 | 1.15 | 1.25 |
Red mud (%) | — | 7.00 | 7.70 | 8.30 |
Limestone (kg) | 2.85 | 2.86 | 2.48 | 2.29 |
Fuel (kg) | 1.00 | 1.00 | 1.00 | 1.00 |
Backstock (kg) | 6.00 | 6.00 | 6.00 | 6.00 |
Water (l) | 2.40 | 2.40 | 2.4 | 2.15 |
Height of layer (mm) | 280 | 280 | 280 | 280 |
Moisture after pelletisation (%) | 7.80 | 7.6 | 8.4 | 7.50 |
Moisture after heating (%) | 7.00 | 7.1 | 8.0 | 7.0 |
Burden temperature (°С) | 80.0 | 81.0 | 81.0 | 81.0 |
Pelletisation degree (%) | 52.8 | 43.4 | 59.6 | 55.8 |
Mechanical durability | ||||
+5 mm (%) | 56.8 | 49.9 | 58.8 | 59.8 |
−0.5 mm (%) | 5.2 | 9.1 | 6.6 | 8.0 |
Granulometric structure (%): +40 mm | 1.0 | 2.6 | 3.5 | 4.2 |
+25 mm | 8.0 | 4.2 | 10 | 12.6 |
+10 mm | 36.1 | 24.2 | 33.5 | 40 |
+5 mm | 26.7 | 24.9 | 24.9 | 15.0 |
−5 mm | 28.2 | 44.1 | 28.1 | 28.2 |
C (burden) (%) | 4.49 | 4.66 | 3.89 | 3.72 |
Fe (agglomerate) (%) | 53.9 | 53.3 | 53.9 | 54.0 |
FеО (agglomerate) (%) | 9.1 | 8.17 | 10.68 | 9.29 |
Basicity (shares of units) | 2.01 | 2.06 | 1.98 | 1.78 |
Content in agglomerate (%) | ||||
C | 0.11 | 0.22 | 0.36 | 0.11 |
V2O5 | 0.51 | 0.48 | 0.47 | 0.49 |
MgO | 2.94 | 2.73 | 2.48 | 2.68 |
Al2O3 | 2.38 | 2.64 | 3.43 | 3.10 |
TiO2 | 2.53 | 2.53 | 2.65 | 2.69 |
S | 0.013 | 0.016 | 0.023 | 0.016 |
Test results of agglomerate production.
Trial tests of production of pellets were carried out in the conditions of JSC Kachkanarsky Mining and Processing Integrated Works GOK. Results are shown in Tables 10–12 (1—0.22% of binding, 1% red mud; 2—0.22% of binder, 2% red mud; 3—binder 0.44%, 4—1% red mud without binder, 5—2% red mud without binder, and 6—0.44% binder).
No. | Burden materials | ||||||
---|---|---|---|---|---|---|---|
Concentrate | Binder | Burden | |||||
Moisture (%) | Dissemination (%) | Moisture (%) | Dissemination (%) | Swelling ability (times) | Moisture (%) | Dissemination (%) | |
1 | 9.3 | 95.4 | 4.1 | 93.2 | 7.6 | 9.15 | 95.5 |
2 | 9.3 | 95.4 | 4.1 | 93.2 | 7.6 | 9.45 | 95.5 |
3 | 9.3 | 95.4 | — | — | — | — | — |
4 | 8.95 | 94.2 | — | — | — | 9.0 | 93.6 |
5 | 8.95 | 94.2 | — | — | — | 8.95 | 93.4 |
6 | — | — | — | — | — | — | — |
The industrial test results of burden materials.
No. | Quality of damp pellets | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Moisture (%) | Plasticity (times) | Durability (kg/pellet) | Granulometric structure (%) | |||||||
Damp | Dry | +20 | +15 | +12 | +10 | +8 | −8 | |||
1 | 8.0 | 5.1 | 1.23 | 3.84 | 13.5 | 40.8 | 21.8 | 18.5 | 4.2 | 1.2 |
2 | 8.85 | 5.8 | 1.46 | 4.0 | 4.2 | 39.1 | 46.0 | 8.8 | 1.6 | 0.3 |
3 | 8.85 | 9.1 | 1.3 | 5.0 | 1.5 | 30.2 | 47.6 | 15.9 | 3.2 | 1.6 |
4 | 9.35 | 13.8 | 1.06 | 1.37 | 0.0 | 12.6 | 19.7 | 24.9 | 36.1 | 6.7 |
5 | 9.55 | 4.3 | 0.7 | 1.54 | 1.9 | 10.3 | 20.8 | 32.0 | 29.0 | 6.0 |
6 | 8.8 | 6.8 | 1.12 | 3.31 | 1.3 | 35.0 | 45.0 | 12.5 | 5.0 | 1.2 |
The industrial test results of pellets.
No. | Burned pellets | |||
---|---|---|---|---|
Compressive strength (kg/pellet) | Laboratory mill | FeO, % | ||
More 5.0 mm | Less 0.5 mm | |||
1 | 231.4 | 96.2 | 2.5 | 2.7 |
2 | 245.2 | 97.0 | 2.7 | 2.5 |
3 | 211.0 | 98.5 | 1.4 | 2.0 |
4 | 251.7 | 96.0 | 3.0 | 2.3 |
5 | 257.6 | 97.5 | 2.5 | 2.1 |
6 | 255.0 | 97.0 | 2.0 | 3.3 |
The industrial test results of burned pellets.
According to the received properties of experimental agglomerates in carrying out laboratory research with an introduction in burden of blast furnace, 1 and 3% of red mud have been calculated. Results of comparative calculations by means of mathematical models [11] are shown in Table 13 [12].
Indices | Unit of measure | Base | Red mud (1%) | Red mud (3%) |
---|---|---|---|---|
Useful volume of furnace | m3 | 2200 | 2200 | 2200 |
Productivity | t/day | 6241 | 6235 | 6141 |
General consumption of ore | kg/t pig iron | 1712.9 | 1728.8 | 1742.2 |
Pellets | kg/t pig iron | 907.8 | 916.3 | 923.4 |
Agglomerate, red mud (0%) | kg/t pig iron | 650.9 | 0.0 | 0.0 |
Agglomerate, red mud (1%) | kg/t pig iron | 0.0 | 657.0 | 0.0 |
Agglomerate, red mud (3%) | kg/t pig iron | 0.0 | 0.0 | 662.0 |
Staflux | kg/t pig iron | 154.2 | 155.6 | 156.8 |
Coke | kg/t pig iron | 396.6 | 394.5 | 397.9 |
Dust exit | kg/t pig iron | 39.1 | 39.4 | 39.7 |
Consumption of natural gas | m3/t pig iron | 125.2 | 125.2 | 125.2 |
Blast: | ||||
Temperature | °C | 1206 | 1206 | 1206 |
Moisture | g/m3 | 8 | 8 | 8 |
Oxygen | % | 28.7 | 28.7 | 28.7 |
Consumption | m3/t pig iron | 925.0 | 924.7 | 936.7 |
Top gas: | ||||
Temperature | °C | 173.9 | 176.7 | 189.5 |
exit | m3/t pig iron | 1474.5 | 1469.1 | 1483.7 |
CO | % | 23.6 | 23.1 | 23.1 |
CO2 | % | 21.9 | 22.4 | 22.3 |
H2 | % | 9.6 | 9.5 | 9.5 |
N2 | % | 44.9 | 45.1 | 45.2 |
Extent of use CO | Shares of units | 0.493 | 0.481 | 0.480 |
Extent of use H2 | Shares of units | 0.464 | 0.457 | 0.460 |
Theoretical temperature of burning | °C | 2006 | 2005 | 2012 |
Composition of pig iron: | ||||
Si | % | 0.10 | 0.10 | 0.10 |
Ti | % | 0.15 | 0.15 | 0.5 |
Mn | % | 0.327 | 0.329 | 0.346 |
Cr | % | 0.105 | 0.106 | 0.112 |
V | % | 0.407 | 0.415 | 0.436 |
S | % | 0.025 | 0.018 | 0.021 |
C | % | 4.666 | 4.666 | 4.666 |
P | % | 0.051 | 0.052 | 0.054 |
Fe | % | 94.17 | 94.16 | 94.11 |
Temperature of metal | °C | 1450 | 1450 | 1450 |
Slag exit | kg/t pig iron | 347.0 | 359.0 | 373.0 |
Composition of slag | ||||
CaO | % | 34.20 | 34.82 | 33.34 |
MgO | % | 9.34 | 9.58 | 9.77 |
SiO2 | % | 27.97 | 25.27 | 25.84 |
Al2O3 | % | 15.83 | 16.79 | 17.34 |
TiO2 | % | 10.38 | 11.32 | 11.07 |
MnO | % | 0.41 | 0.41 | 0.43 |
Cr2O3 | % | 0.05 | 0.05 | 0.06 |
V2O5 | % | 0.25 | 0.23 | 0.26 |
S | % | 0.80 | 0.77 | 0.76 |
R2O | % | 0.57 | 0.54 | 0.91 |
FeO | % | 0.61 | 0.61 | 0.60 |
CaO/SiO2 | 1.22 | 1.38 | 1.29 |
Calculated indicators of blast furnace smelting of agglomerate with additives of red mud.
The analysis of results shows that positive improvement in durability of the agglomerate when using red mud is practically levelled by a decrease in the general content of iron in the burden. To save the content of iron at the level of its base values in the burden of blast furnace smelting, it is possible to use several options: a decrease in basicity of the high-basicity agglomerate, along with a simultaneous raise in the relation of CaO/SiO2 in Staflux, the addition of a new iron-containing component in the agglomerative burden (scale), and the replacement of part of the bentonite in mud in the production of pellets.
Laboratory tests, calculations, research, and industrial tests have confirmed the possibility of red mud utilisation as a ferriferous additive (agglomerate) and binding as a bentonite substitute (pellets).
This research study was supported by the State Task of Institute of Metallurgy of the Ural Branch of the Russian Academy of Sciences, the Project No. 0396-2015-0081.
The author declares no conflict of interest.
The author expresses gratitude to Leopold Leontyev, Galina Gazaleeva, Evgeniy Bratygin, Dmitriy Volkov and Yuriy Chesnokov.
The life expectancy is increasing every decade, and the lens of the eye decreases their optical quality over the years [1]. If we could live the number of years what is expected, everybody will have cataracts and will need a cataract surgery. That is a fact. Cataracts are still a leading cause of moderate to severe visual impairment, even blindness worldwide [2–4]. Visual impairment caused by cataract leads to not only an economic loss but also the impaired quality of life [5]. However, cataract is easily treatable by surgery [6]. On the other hand, there are different studies trying to find how cataracts could be prevented [7–9]. In the future, cataractogenesis could be totally elucidated, and maybe cataract surgery will not be necessary. However, until today, the only way to resolve this problem is by a surgical procedure.
Science and technology improve ophthalmology performance to protect the sight. Today, a cataract surgery takes only a few minutes, with topical anesthesia, with sutureless, and with a very fast visual recovery. Moreover, cataract surgery research in this field progresses continuously. And it always is possible to improve for tomorrow what we are doing now. The chapter which I want to share with you is exactly about that: how we could improve cataract surgery technique, with the same surgical equipment usually employed.
I have begun performing cataract surgery since 22 years ago. When I learned to operate cataracts, extracapsular was the surgical technique of choice, without the aid of viscoelastic substance. Their use at those years was not extended widely. And surgeries went well. After that, phacoemulsification technology produces a revolution, improving surgical outcome. At the same time, the intraocular lens (IOL) industry grew up, as well as viscoelastic substances spread worldwide and were included as one necessary medical supply for the surgery. Viscoelastic substance appears to resolve a lot of problems, which could arise when the anterior chamber is opened [10, 11].
The anterior chamber space preservation is relevant to avoid endothelial complications [12]. If anterior chamber space is flattened, the iris could be damaged, the corneal endothelium could suffer, and all of the work inside the eye are riskier. New surgeon generation from developed countries learns to operate cataracts with phacoemulsification equipment using viscoelastic substance as the gold standard technique. And today, femtosecond laser technology is growing and possibly in a close future takes the place of phacoemulsification technique completely. However, more machines, more devices, and more medical supplies are increasing their final cost and not necessarily increasing their visual and refractive results over other techniques. Moreover, there are many surgeons around the world, in developing countries, where that sophisticated technology is not accessible. They help people without an expensive medical device and without viscoelastic substance and still perform cataract surgery by extracapsular technique [13]. The Blumenthal technique of manual small-incision cataract surgery (MSICS), with the help of anterior chamber maintainer, has been proven safe and effective, preventing endothelial cell loss during surgery [14, 15].
Why have I developed this technique to perform phacoemulsification cataract surgery without the aid of viscoelastic substance? After one scientific meeting in Vienna, Austria (European Society of Ophthalmology 2015), I was thinking about the way to decrease my surgery time, simplify the technique without increasing risk, and if possible improve my personal surgery outcome. There are published descriptions to avoid the use of viscoelastic substance during IOL implantation [16, 17] with good results. First, I began doing that and it was fine. However, I want to avoid the use of viscoelastic substance at all. Could capsulorhexis and hydrodissection have been performed without viscoelastic substance safely during phacoemulsification technique? The answer is yes, and also, avoiding completely the use of viscoelastic substance, it could have relevant advantages, as I will describe in this chapter. I propose to myself to perform and develop phacoemulsification cataract surgery without viscoelastic substance. I will share my experience, my technique tips, indications, contraindications, and why today this is my first choice technique to perform cataract surgery.
Since the 1970s, viscoelastic substance begins to progress, and today they are popular and indispensable for integral parts of intraocular surgery [18]. The main purpose for using viscoelastic substance in cataract surgery is to maintain a stable anterior chamber depth and protect the corneal endothelial cells from being damaged [11]. That decreases surgical complications and makes challenging cases easier. For example, there are cases called “intraoperative floppy iris syndrome,” which was associated with tamsulosin, a systemic α-1 blocker used to treat benign prostatic hypertrophy [19]. The clinical intraoperative triad of the syndrome consists of fluttering and billowing of the iris stroma caused by ordinary intraocular fluid currents, a propensity for iris prolapse through the phacoemulsification and/or side-port incisions, and progressive constriction of the pupil during surgery [19]. Also, viscoelastic substance is sometimes helpful to tamponade a posterior capsule rupture for subsequent IOL implantation [20] or to inject viscoelastic substance through a pars plana incision to elevate the nuclear pieces into the anterior chamber [21].
However, there are studies which describe problems related with viscoelastic substance. The IOP elevation by viscoelastic substances is caused by a reduction of aqueous outflow due to blockage of the trabecular meshwork where the fluids exit the eye, which was first published in 1990 [18] and later confirmed by other authors in vivo and in vitro [10, 22, 23]. Therefore, complete removal of viscoelastic substance is recommended after IOL implantation. The IOP elevation is usually transient, peaking at 4–7 h postoperatively and returning to baseline within several days, but the maximum IOP may exceed 30 mmHg. Therefore, careful monitoring of IOP and IOP-lowering therapy may be necessary, especially in patients with glaucoma who have a compromised outflow facility.
Flare or Tyndall effect could be postoperatively detected after cataract surgery, which in part is frequent, but in excess that could be the manifestation of “toxic anterior segment syndrome” (TASS) after cataract surgery, and viscoelastic substance could be associated with this [23, 24]. Also, an extra surgery time is necessary to introduce viscoelastic substance and to completely remove them from the anterior chamber, trying to avoid the problems previously described. Moreover, viscoelastic substance increases the final cost of the surgery. In conclusion, viscoelastic substances could help to perform a more secure surgery, especially in some cases, but also could be the cause of other problems, sometimes serious. Because of that, this work emphasizes and proposes a special technique to perform phacoemulsification cataract surgery without viscoelastic substance.
As any surgical technique, specific indications and contraindications (inclusion/exclusion criteria) will be described, to choose the appropriate case or to exclude patients with high risk:
Include patients with cataracts classified as NO1–NC1 to NO4–NC4 according to the LOCS III classification (avoid NO5–NC5, NO6–NC6).
Exclude patients with less than 2000 endothelial cell count preoperative. Endothelial cells count evaluation is necessary to be included as a standard preoperative test, and it is advisable to perform as postoperative standard follow-up test.
Exclude patients with endothelial defects, pseudoexfoliation, posttraumatic cataracts, pupil synechiae or small pupil, uveitis, and/or previous vitreoretinal surgeries.
Include only patients programmed to implant foldable one-piece intraocular lens (IOL) models with injector.
Exclude patients when three-piece IOL models are programmed to implant. I do not recommend those kinds of IOLs for this procedure because their haptics are hard and the capsule could be broken.
When a new surgical technique is presented, there are many questions to be answered. I will try to describe all of the details because I hope many surgeons worldwide probe it with success. One first question: will it be necessary to acquire new equipment, devices, and/or machines? The answer is no. The technique could be correctly performed with different standard phacoemulsification equipment, and any surgeon who perform phacoemulsification with viscoelastic technique could perform the Bianchi’s method without viscoelastic substance. Hand positions and movements are similar to “microincision cataract surgery” (MICS). It is just necessary to get a micro-capsulorhexis forceps of 1.1 mm diameter, which must have the same diameter of the irrigation cannula. From standard surgical instruments usually employed to perform phacoemulsification, you will only need the irrigation cannula, but the aspiration cannula is not necessary. Figure 1 shows the specific surgical tools.
Surgical instruments necessary to perform Bianchi’s method. (a) MST Touch Handle and 23g Micro-Holding Forceps for capsulorrhexis; (b) Curve and straight Micro-Scissors; (c) capsulorrhexis micro-forceps and (d) I/A irrigation cannula.
Topical anesthesia must be performed as usual and then:
Two clear corneal incisions of 1.1 mm were performed with v-lance near the limbus. The first was at “2” o’clock and the second at “10” o’clock.
Immediately after the first incision was performed, the irrigation cannula (1.1 mm diameter) was introduced, the second incision was performed, and the micro-capsulorhexis forceps of 1.1 mm diameter was introduced. The size of the v-lance and the irrigation cannula must be the same to avoid leakage through the corneal incision.
The irrigation bottle with balanced salt solution (BSS) must be elevated usually at 80–100 cm above the patient’s head level, under continuous irrigation (no more, to avoid IOP increase), to obtain a deep and stable space in the anterior chamber. The irrigation cannula has two lateral vents, which let the BSS leave and move in a centripetal way, toward the equator. That means the liquid circulation is not against the endothelium; therefore, the endothelium is protected. For the learning curve, in the first case, it is recommended to put in the automatic or continuous way the irrigation mode of the phaco. This lets to maintain stable the anterior chamber automatically. With more experience, the surgeon can manage them with the phaco pedal.
This bimanual technique is suitable for right- or left-handed surgeons. The previous description is for right-handed surgeons. For left-handed surgeons, “2” o’clock incision is for micro-capsulorhexis and the cannula must be located at “10” o’clock incision.
Capsulorhexis was performed (Figure 2), while the liquid (BSS) circulation in the anterior chamber produces a positive pressure, which determines a stable and safe space to work. This is one of the most important points of the technique. It is easier to perform the capsulorhexis under positive pressure than under negative pressure (as what happens with viscoelastic substance), because continuous irrigation flattens the anterior face of the lens. When you are working under positive pressure into the anterior chamber, it is very rare to have the problem of capsulorhexis rupture. In my experience, capsulorhexis failure was more frequent with viscoelastic substance than those cases performed without viscoelastic substance.
After that, hydrodissection was performed with the same irrigation cannula until a complete rotation of the nucleus was observed (Figure 3). Perform this step carefully, because if you push too much the nucleus, the zonnula could be broken. However, it is not difficult to perform the hydrodissection: simply, let the irrigation cannula position below capsulorhexis, and the liquid diffuses around the nucleus to release it. Or sometimes, a circular movement of the cannula could be performed to facilitate that the nucleus will be released from the epinucleus. Then, the rotation of the nucleus will easily occur.
Phacoemulsification, aspiration, and mass extractions: it will be performed without any difference from a standard procedure (Figure 4).
Next step: without removing the cannula, the second corneal incision must be increased (Figure 5) according to the phaco tip, for the IOL implantation (1.8 mm, 2.2 mm up to 2.8 mm or what the surgeon need) (Figure 6). Only foldable one-piece IOL models with injector could be used. Three pieces IOL models are not recommended for this procedure. When the intraocular lens cartridge was introduced through the incision, the anterior chamber could suffer a space reduction due to BSS outflow, but immediately after the IOL injection begins, liquid leakage stops, and the anterior chamber space is restored. The positive pressure expands the capsular bag, and then the IOL is placed with the cannula to help during the unfolding process to obtain the correct IOL position. Also, this procedure let the toric IOLs be easily rotated, if it was necessary. This is another advantage of this technique against standard technique with viscoelastic substance, because sometimes, after removing viscoelastics, toric IOLs could be displaced and are necessary to correct their position again, to obtain the exact location for astigmatism correction.
This figure shows from “a” to “e” the capsulorhexis procedure with continuous liquid circulation into the anterior chamber.
Hydrodissection step performed with the irrigation cannula and from “a” to “d” is possible to see the nucleus rotation.
Phacoemulsification, aspiration, and mass extraction were performed as usual.
This figure shows the second corneal incision enlargement.
One-piece intraocular lens is placed in an injected.
FinalIy, I usually inject an intracameral antibiotic (cefuroxime) and the surgery concludes. Most of the surgeries were performed between 4 and 5 min or 6 and 7 min for harder cataracts.
Performing cataract surgery without viscoelastic substances seems to be dangerous for the corneal endothelial tissue. However, with the surgical steps previously described, it is true? To evaluate and control this matter, since my beginning with this technique (July 2015) and after 1500 operated cases, all of the patients are still followed with endothelial cell count and central corneal thickness evaluation (always at the preoperative time and, then, at least 6 months post-op with endothelial cell count follow-up).
A prospective comparative study is ongoing, to evaluate clinical outcomes and complications between both techniques: phacoemulsification with and without viscoelastic substance by Bianchi’s method. I can advance some data from this study, as a brief preliminary report. The patient’s age was 45–91 years old; none of them has suffered intraoperative or postoperative complications as capsular bag rupture, IOL implantation problems, expulsive hemorrhage, IOP elevation, TASS, and/or endophthalmitis. All of the patients improve their visual acuity. Endothelial cell count and central corneal thickness were compared between patients operated with and without viscoelastic substance, and nonstatistical significant difference was found between both groups. The surgical time with Bianchi’s method is between 4 and 5 min (7 min maximum) and for standard phacoemulsification with viscoelastic is 8–10 min (for this study, the surgeon was German Bianchi MD for all of the procedures). Why is the surgical time shorter? Because an extra time is needed to insert and completely remove the injected viscoelastic substance. Besides a prolonged operation time, which per se increases overall operation risks and complications, viscoelastic substance removal can immediately affect safety issues. Also, an increased irrigation-aspiration time might also be responsible for endothelial cell loss due to the aspiration trauma. The use of a viscoelastic substance can have side effects and may cause endothelial damage as well.
Even though it is an ongoing study, preliminary data plus the experience of 2 years doing this technique with good outcomes let me confirm that it is secure, fast, and simple. Now, it is my first choice to perform cataract surgery.
I have started to teach this technique to the ophthalmic residents of the clinic where I work, and they told me “it is not difficult” and also the learning curve is fast. However, some colleagues previously told me: “well, is easy for you… but not for everybody!.” No, today I can confirm that the Bianchi’s method to perform cataract surgery without viscoelastic substances is easy, for any ophthalmic surgeon who used to perform phacoemulsification technique or MICS.
Schulze et al. [25] avoid their use, only during IOL implantation, without finding difference in endothelial cell loss. Oksuz et al. [26] described a technique without VS to perform capsulorhexis, but they use it after hydrodissection and for the IOL implantation. Finally, they aspirated it from the anterior chamber.
In the past, Wright et al. [13] compare their results of small-incision extracapsular cataract surgery using the anterior chamber maintainer without viscoelastic substance, and they finally show that the magnitude and range of the endothelial cell losses associated with this technique are significantly greater than those described following phacoemulsification. Because of that, these authors finally recommend the use of VS for this extracapsular procedure.
But in 2008, Sallet [27] described a phacoemulsification cataract surgery technique completely performed without VS, where he found no difference in their clinical outcome comparing it with 50 patients operated with VS. However, Galan [28] previously performed a similar technique with 1.6 mm corneal incision and enlargement to 3.0 mm for IOL implantation with less success rate than Sallet G, which Sallet considered could be due to the narrower incisions performed by him of 1.2 and 2.6 mm for IOL implantation. The technique described in this work proposes two corneal microincision, which is 1.1 wide and the enlargement of one of those to 2.2–2.8 mm according to the phacoemulsification tip (Sallet G open 2.6 mm). Small corneal incisions could be in part the key to obtain better surgical results. Another difference with the technique described by Sallet G is about hydrodissection: in the present technique, it is performed by the irrigation cannula.
This new technique is not more expensive. In fact, it is more economic, because it is not necessary to buy viscoelastic substances. In the country where I live, the final cost of the surgery increases US$75 per procedure when viscoelastic substance (I use DisCoVisc®) is necessary.
However, as in this chapter was described, there are many patients where viscoelastic substances are not necessary: not only because it increases the surgery cost but moreover because they could be a potential problem, which disrupts the surgical outcome.
As it was mentioned at the beginning of this chapter, lifetime expectancy increases as well as ocular tissues grow older. Our eyes are not prepared for the last years that we are living. Cataracts appear and the possibility to replace them with an IOL let many people stay able to keep their sight and quality of life. Moreover, the improvements in the surgical techniques, device, equipment, and tools let today to resolve high orders of refractive problems with the IOL implantation (with or without removing the lens). The procedure to implant an IOL into the eye is short, simple, and secure. But it is always possible to improve and adequate techniques to different environments.
The technique described in this work was presented in the XXXV Congress of the European Society of Cataract & Refractive Surgeons (ESCRS Lisbon 2017) at the Video Awards Session. There is a mini-review published in September 2017 [29]. Also, the video of the technique could be showed in
Below is the list of advantages and limitation.
Advantages:
Avoid complications related with viscoelastic (IOP elevation, TASS) and corneal endothelial damage during the viscoelastic substance aspiration.
Perform a fast surgery (4–5 min usually, 6–7 min at maximum).
Work all the time under positive pressure in the anterior chamber; this let the capsulorhexis becomes easily performed.
Short learning curve: usually new cataract surgeons only learn to operate phacoemulsification cataract surgery with viscoelastic substances. I’m not against viscoelastic substance, which is really useful for some cases, although, for other cases, it could be possible to perform a safe procedure without viscoelastic substance, moreover, with “extra” advantages!
Surgery cost: the final cost of the surgery decreases for the patient, because you do not need an extra medical supply (you do not need to buy viscoelastic substance for each surgery). And as my scrub nurses happily told me, they also prefer it. Why? Micro-capsulorhexis forceps cleaning and maintenance are more easy when I use BSS than viscoelastic substances. And also, that increases the lifespan of my surgical tool. For all of those reasons, it decreases the total surgical economical cost.
One more advantage: you do not need a third-hand incision.
What are the limitations or contraindications?
Avoid “hard” cataracts.
Avoid three-piece IOL.
The technique is not recommended for patients with endothelial corneal pathology, pseudoexfoliation syndrome, traumatic cataracts, and/or history of previous vitreoretinal surgery. However, in those cases, the standard phacoemulsification procedure will also increase the surgical risk. Endothelial corneal transplantation or complete perforated corneal transplant could be necessary at the end because of bullous pseudophakic keratopathy and the consequent corneal edema.
Endothelial cell count is a mandatory preoperative study, and I recommend follow-up 6 months after surgery. I know that some places do not have an endothelial cell counter analyzer, but it is a study which I think is relevant to perform not only the Bianchi’s method, moreover, for every patient who will need a cataract surgery. Today the people have great expectative about their refractive surgical outcome after cataract surgery, and if a patient has an endothelial problem and if it was possible to have an objective data about it, the surgeon could decrease patient’s expectative and explain to him which could be his specific surgical risk, before performing the surgery. I emphasize this point. It is a really important issue to prevent legal problems.
If capsulorhexis goes wrong, always convert to viscoelastic standard technique.
Hydrodissection must be performed without pressing over the posterior capsule to avoid rupture.
Doing the IOL implantation should be obtained in a well expanded anterior chamber, but if not, use viscoelastic substance.
In summary, a bimanual phacoemulsification microincision cataract surgery could be performed without the aid of viscoelastic substance, decreasing their economical cost during 5–7 min. The technique is easy to learn and potentially with fewer complications, which must be scientifically demonstrated in a prospective study (which is an ongoing study), and even better in a multicentric study to confirm that this technique is efficient and reproducible for different ophthalmic surgeons.
And finally, to end this chapter, I want to share with you a little story.
My professor was Dr. Hugo Dionisio Nano, one of the most important ophthalmologists in Argentina, with international recognition around the world. Dr. Nano, with his age of 88 years old, usually goes to his clinics, goes to scientific meetings, and still is an active “ophthalmology teacher” for many colleagues. In 2016, he needed a cataract surgery and chose me as his surgeon, a great honor and a great challenge for me. For his first eye, I have performed the standard phacoemulsification cataract surgery, with viscoelastic substance. Surgery went fine with no complications. However, he had a moderate postoperative inflammation and intraocular pressure rise, which resolved a few days later. One week after, I chose to operate his second eye without viscoelastic substance (Bianchi’s method), and he did not have any postoperative problem. This is one anecdote I know, but I hope with this chapter, I could give you enough scientific information and technical tips to encourage you and try “Bianchi’s method” in your next cataract surgery.
To my wife Carolina and my children, Lucía, Sofía, Manuel, and Giulietta, thanks for all of your patience and for the time you give me to perform my profession.
To my surgical team: thanks for your professionalism and continuous dedication.
To my mother, who encouraged me every day to study, and to my father, who always guided me from the sky, thank you.
I would like to thank Dr. Rodrigo M. Torres, for his motivation and scientific advice to perform medical studies.
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