Posters

Evaluation of bore and chop a new technique of phacoemulsification in small pupil cataract surgery without using adrenalin hooks or rings

Poster Details

First Author: R.Odeyar INDIA

Co Author(s): S. Shaha                    

Abstract Details

Purpose:

To evaluate the advantages and safety efficacy of new method of Bore And Chop technique of phacoemulsification in hard cataracts with small pupil without using adrenaline , hooks , rings or manual dilators .

Setting:

Swapnil Eye And Laser Centre In all cases capsule was stained with trepan blue and capsulotomy performed with needle just outside pupillary margin .To drill bore in nucleus 2.2 or 2.8 mm flared phaco tip was used and to chop the nucleus blunt chopper with inner cutting edge was used.

Methods:

138 cases of cataract with small pupil   were operated between February 2018 and September 2019 with this new technique Inclusion criteria: Grade 3 and 4 nuclear cataracts with pupil size 3 mm to 5 mm or less during surgery Exclusion criteria: Small pupil with grade1 and grade 2 cataracts and small pupil with posterior synachiae. In all cases 2.8 mm flared phaco tip was used to drill bore in hard core of nucleus and blunt chopper with inner cutting edge was used to chop the nucleus in capsular bag.Emulsification was carried out at pupilary plane.

Results:

Sample size :138 cases Complications :Posterior capsule rent : 2 cases managed with iris claw lens                          Phaco tip touch to Iris 3 cases                          Postoperative pupi distortion 2                          Grade 1and 2 striate keratitis 3 cases recovering within 4 days. Advantages : Cost of pupil dilating devices is saved                        Time to implant and explant pupil dilating devices is saved.                        Adrenalin is not used so safe in cardiac patients.                        No manual dilation so less postoperative pupil distortion. Disadvantages : Steep learning curve . Technique has to be mastered in hard cataracts with dilated pupils before attempting in small pupil.

Conclusions:

The incidence of  posterior capsule rent and striate keratitis is comparable to routine phacoemulsification cataract surgery  Though the technique requires higher degree of surgical skill, From the results we can conclude that this new technique of Phacoemulsification is safe in small pupil and reduces  the cost and surgical time  need for implantation and explanations of iris hooks or pupil expanding rings. Also as adrenalin is not used to dilate the pupil the technique is safe in cardiac patients. It can also be done under topical anesthesia in cooperative patients.

Financial Disclosure:

None