Dropped Nucleus-When Does it Happen and what should be Done-A Review in one Center

Abstract

nuclei, subsequent complications and management and final visual outcome were noted. RESULTS: Eight dropped nuclei occurred during various stages of cataract surgery contributing 0.6% of total cataract operations. Not stopping phaco once a posterior capsule rupture (PCR) occurred, lead to dropped nucleus. Pars plana vitrectomy (PPV) was delayed or not done -leading to rise in intraocular pressure with resultant punctate epithelial erosions and retinal detachment and poor visual outcomes. CONCLUSION: PCR must be recognized and appropriate steps taken to prevent a nucleus from dropping. Once a nucleus has dropped, early PPV should be done to prevent further complications that lead to poor vision. INTRODUCTIONCataract is a leading cause of blindness in Malaysia (39%) [1] . A dropped nucleus is a nightmare for any cataract surgeon. First a posterior capsule rupture occurs, and if not recognised and managed appropriately, can lead to a dropped nucleus which can then lead to a series of other complications such as raised intraocular pressure, corneal decompensation, cystoid macula oedema and retinal detachment which compromise vision.Melaka Hospital is a state hospital serving a population of 821, 110 [2] . Cataract surgeries are done by Specialists, Gazetting Specialists (Specialists who have passed postgraduate exams but are still under supervision) and Medical Officers. Due to a recent increase in dropped nuclei occurring during cataract surgery, this study was undertaken to study factors causing and associated with dropped nuclei in order to minimize the occurrence in future. A study on point of occurrence of posterior capsule rupture has been conducted in the hospital [3] . ABSTRACT AIM: A dropped nucleus is a nightmare for any cataract surgeon but as in all surgeries, complications are unavoidable. What is important is to recognize the occurrence of complications and to identify the causes and take measures to prevent them in future. We recently had a rise in dropped nuclei occurring in our center. This study was done to identify causes and associations of dropped nuclei in order to improve patients' outcomes.