Posters

Trench-rotate-chop: new technique for hard nucleus cataract phacoemulsification

Poster Details

First Author: C.Kalamkar INDIA

Co Author(s):    A. Mukherjee   R. Rao                 

Abstract Details

Purpose:

Since cracking hard nucleus in phacoemulsification (PE) is one of the most difficult and complication prone step, we describe a new technique “trench-rotate- chop” to improve ease and safety of chopping hard nucleus. With this technique hard nucleus can be fully cracked into two complete segments including the posterior plate.

Setting:

tertiary care eye hospital. 55 adult eyes with hard nucleus (nuclear opalescence 5 or more according to LOCS III) underwent this technique.

Methods:

A small central 2.5mm-3mm deep trench was created in the nucleus. The nucleus was rotated 90 degrees so that trench becomes horizontal and phaco tip now faces one of the horizontal trench walls. Tip was buried deep into the base of the wall and vertical chopping was initiated opposite to it ensuring half cracking of nucleus till trench. Nucleus was again rotated so that the tip now faces unchopped wall of the trench exactly opposite to initial crack. Similar chopping was initiated culminating in merger of both cracks and complete nucleus segmentation into two parts.

Results:

PE was safely performed in all cases. None of the cases had zonular dialysis, posterior capsular rupture or vitreous loss intra-operatively. All cases had clear cornea on post-operative day 1. Full thickness nucleus cracking was achieved in all cases. At 3 months post-operative 53 eyes (96.4%) had BCVA 20/20 and 2 eyes ( 3.6%) had 20/40.

Conclusions:

Our modified technique for chopping hard nucleus during PE ensures complete nucleus separation with less energy usage. Risk of complications, commonly associated with hard cataract PE, is also reduced.

Financial Disclosure:

None