Manual sutureless cataract surgery using a claw vectis

Two-handed sandwich methods of extracapsular cataract extraction using a self-sealing incision have proved difficult for many inexperienced surgeons. We developed a simpler 1-handed technique using a claw vectis-a vectis with a claw placed on its tip. When the nucleus is pulled through the scleral tunnel, it is fixed by the claw and is smoothly removed from a wound of a size comparable to that in the sandwich method. During nucleus removal, viscoelastic material is constantly injected through the irrigation vectis to maintain the anterior chamber depth, resulting in a low incidence of complications. We have performed 620 cases using the technique and found it safe and easy for both novice and experienced surgeons.