The Kebab Technique: Using a Bipolar Pencil to Retrieve a Dropped Nucleus via a Small Incision

Abstract

We developed a new method to retrieve a dropped nucleus via a small incision using bipolar pencils, the kebab technique, to solve the lack of small-gauge fragmatomes, and the expense and toxicity of perfluorocarbon liquids (PFCL). A total of 8 eyes in 6 patients underwent this technique and were reviewed. After vitrectomy, the dropped nucleus was lifted from the retina by adhesion with a bipolar pencil, and phacoemulsification was performed while rotating the lens. The outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), and corneal endothelial cell density before and after surgery. Surgical indications included zonular weakness, trauma, acute angle closure attack, and phacolytic glaucoma. At 1 month, BCVA improved from a mean ± SD 1.67 logMAR (± 0.90) to 1.14 logMAR (± 1.01). The mean preoperative intraocular pressure (IOP) was 24.5 (± 16.8) mmHg and postoperative IOP was 11.0 (± 2.8) mmHg. The mean preoperative corneal endothelial cell count was 2600 (322) cells/mm2 (one eye was unmeasurable) and postoperative corneal endothelial cell count was 2387 (± 431) cells/ mm2. There were no postoperative complications. The retrieval of a dropped nucleus using a bipolar pencil enables small incisions without using PFCL.