DR. RAKHI P DCRUZ

Abstract

Posterior polar cataracts are associated with thin and fragile posterior capsule with the discoid opacity being adherent to it,/ in upto 20% of cases the posterior capsule may be congenitally deficient.Surgery of PPC hence remains a surgical challenge.Reported rates of PCR in these eyes vary from 0-36%.

There are several techniques described earlier- inside out hydrodelineation by Vasavada et al, “λ technique of nucleofractis”, & layer by layer phacoemulsification by Vajpayee.We are adopting a combination of these techniques.

Unique steps in our surgical video includes

1.Multiquadrant multilayered hydrodelineation

2.Central nucleus -minimal sculpting

3.Layer-by-layer phacoemulsification of nucleus with low ultrasound parameters

4.Controlled sequential aspiration of epinuclues leaving behind central plaque

5.Phacoemulsification of central plaque aided by second instrument

6.Multiquadrant slow aspiration of cortex

7.In the bag placement of IOL with minimal disturbances to the capsule