Two-hook technique for nucleus extraction in manual sutureless extracapsular cataract extraction

Nucleus extraction in manual sutureless extracapsular cataract extraction (ECCE) using the 2-hook technique is described. After capsulorhexis and hydrodissection are performed, the nucleus is moved into the anterior chamber and extracted by pulling with a Sinskey hook and pressuring the scleral bed with a Kuglen hook. In a series of 1320 eyes, 85% achieved a corrected visual acuity of 5/10 or better postoperatively. Complications were posterior capsule rupture, vitreous loss, and transient corneal edema. Manual sutureless ECCE using the 2-hook technique is safe and efficient and does not require expensive instrumentation.