Posterior segment nucleotomy for dislocated sclerotic cataractous lens using chandelier endoilluminator and sharp tipped chopper

Brijesh Takkar; Rajvardhan Azad; Shorya Azad; Anubha Rathi

doi:10.3980/j.issn.2222-3959.2015.04.33

Posterior segment nucleotomy for dislocated sclerotic cataractous lens using chandelier endoilluminator and sharp tipped chopper

Int J Ophthalmol. 2015 Aug 18;8(4):833-4. doi: 10.3980/j.issn.2222-3959.2015.04.33. eCollection 2015.

Authors

Brijesh Takkar¹, Rajvardhan Azad¹, Shorya Azad¹, Anubha Rathi¹

Affiliation

¹ Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.

PMID: 26309887
PMCID: PMC4539630
DOI: 10.3980/j.issn.2222-3959.2015.04.33

Abstract

Aim: To describe a new surgical technique for managing dislocated sclerotic cataractous lens.

Methods: Six patients with advanced posteriorly dislocated cataracts were operated at a tertiary care centre and analyzed retrospectively. After standard 3 port 23 G pars plana vitrectomy and perfluorocarbon liquid (PFCL) injection, the dislocated white cataract was held with occlusion using phaco fragmatome and then chopped into smaller pieces with a sharp tipped chopper using 25 G chandelier endoilluminator. Each piece was emulsified individually. Following aspiration of PFCL, Fluid Air Exchange was done in all the cases and surgery completed uneventfully.

Results: Best corrected visual acuity (BCVA) in all the patients was better than 6/12 after one month of follow up. No serious complications were noted till minimum 6mo of follow up.

Conclusion: Four port posterior segment nucleotomy with a chandelier endoilluminator, fragmatome and a chopper appears to be a safe, easy and effective procedure for managing dislocated sclerotic cataractous nuclei. Ultrasonic energy used and adverse thermal effects of the fragmatome on the sclera may be lesser.

Keywords: complications of phacoemulsification; dislocated hard lens; dislocated lens; dislocated sclerotic lens; intravitreal nucleotomy; posterior segment nucleotomy.