Incidence and practical management of dropped nuclei

Session Details

Session Title: Evolution in FLACS & Phaco Technology

Session Date/Time: Sunday 23/09/2018 | 08:00-09:45

Paper Time: 09:32

Venue: Room A3, Podium 2

First Author: : J.Ng UK

Co Author(s): :    D. Vaideanu-collins                    

Abstract Details

Purpose:

Dropped nucleus is a rare but feared intraoperative complication during cataract surgery. If managed properly, the outcome can be as good as it had never happened. The aim of this audit is to establish the incidence and common management practice in dropped nucleus cases in James Cook University Hospital, UK and recommend a local protocol for its safe management.

Setting:

James Cook University Hospital, Middlesbrough, UK

Methods:

Retrospective case note review. Demographic, risk factors, intraoperative issues, postoperative treatment regime, timeline to vitrectomy and final visual outcome were analysed.

Results:

There were 21 cases of dropped nuclei in 11331 phacoemulsification cases (0.2% incidence). The median preoperative and postoperative VA was 6/18 and 6/9 respectively. We found that dropped nucleus most frequently occurred during quadrant removal (46%). 92% cases had anterior vitrectomy intraoperatively and 62% had IOL implantation during primary procedure. The time from primary surgery to PPV was 2.7 days.

Conclusions:

The Incidence of dropped nucleus in our unit compares with national data. Following this audit, we developed standardised local protocol for dropped nucleus, and planned to have vitrectomy dummy run for the trainees in order to prepare them better to overcome this complication. We also recommend to set aside prepacked anterior vitrectomy kits.

Financial Disclosure:

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