A Clinical Study Comparing Different Techniques of Nucleus Delivery in Manual Small Incision Cataract Surgery

Abstract

Aim: To compare different technique of nucleus delivery in small manual incision cataract surgery,regarding their safety and intra operative complication. Material & Methods: A total of 285 patients with cataract undergoing SICS with posterior chamber IOL implantation were selected. Patients were randomly divided into 7 groups of nucleus delivery. All of the patients were followed up on first postoperative day and discharge. Patients were advised regular follow up at 1 st week, 4 th week and 6 th week. Results: Out of total 285 patients 68 (23.86%) patients had intraoprative complications for all the techniques. There was no intraoperative difficulty to the surgeon for delivery of nucleus by various techniques in 210(73.68%) of cases. Group 1 (wire vectis) had minimum intraoperative complications whereas group 2 had maximum.31 (10.88%)had grade 1 (minimal) difficulty intraoperetively. 25 (8.77%)cases had grade 2 (moderate) difficulty. 19 (6.67) cases had grade 3(abandoned) difficulty. Conclusion: By adjusting parameters like size of cornean incision, hydrodissection or debulking of nucleus before delivery of nucleus in different grades of hardness of cataract, a surgeon may choose any one technique in which he or she is comfortable. Manual small incision Cataract surgery with its low complication rate has now come to be established surgical procedures for cataract surgery.

Fish hook technique for nucleus management in manual small-incision cataract surgery

“…[ 4 ] Another prospective study by Patil et al . [ 9 ] have documented the intraoperative complication rate with a fish hook to be as high as 57.58%. This probably could be due to the use of hooks made from 26 ½ gauze needles, which are thicker than the ideal fish hook.…”

“…Capsular dialysis and intracapsular cataract extraction (ICCE) are other dreaded complications in inadequately sized capsulorhexis. [ 4 5 9 ]…”