Dr. GANESUNI RAJESH

Abstract

HARD CATARACT IS FACED BY ALL SURGERONS IN THEIR DAY TO DAY SURGERY. IT IS

ALWAYS VERY DIFFICULT TRYING TO MANAGE THESE HARD CATARACTS, PARTICULARLY

WHEN TRYING TO BREAK THE NUCLEUS INTO NUMBER OF PIECES. SOMETIMES THE

POSTERIOR PLATE OF THE NUCLEUS MAY BE VERY HARD OR LEATHERY AND WHILE

USING DIFFERENT MANOEVOURS AND CHOPPING TECHNIQUES, THERE IS A RISK OF

CAUSING A POSTERIOR CAPSULE RENT AND ZONULAR DIALYSIS, etc; THE SOLUTION TO

THIS IS TO HAVE ACCESS OF THE HARD POSTERIOR PLATE OF THE CATARACT DIRECTLY

TO THE PHACO TIP. THIS CAN BE ACHIEVED BY FLIPPING THE NUCLUES 180 DEGREE –

“SOMERSAULT”. THIS CAN BE DONE IN ALL GRADES OF CATARACTS FOLLOWING THE

GUIDELINES AND IS FOUND TO BE SAFE AND VERY USEFUL IN THE HARD CATARACTS.

IT IS NOTICED THAT THERE IS NO EXTRA DANGER EITHER TO THE POSTERIOR CAPSULE OR THE CORNEAL ENDOTHELIUM AND ALSO THE EFFECTIVE PHACO TIME AND THE EFFECTIVE PHACO ENERY USED IS LESS

WITH THIS TECHNIQUE COMPARED TO OTHER TECHNIQUES FOR SIMILAR GRADE OF

CATARACT.