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

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.