Phaco-handpiece used as a Fragmatome for managing nucleus drop

Area of Science:

• Ophthalmology
• Surgical Techniques
• Retina

Background:

• Nucleus drop during cataract surgery is a serious complication requiring prompt vitreo-retinal intervention.
• Fragmatomes are the standard management tool but are not universally available in routine setups.
• Phaco-probes are widely available and offer a potentially cost-effective alternative.

Purpose of the Study:

• To demonstrate the efficacy of a phaco-probe as a substitute for a fragmatome in managing dropped nuclei during cataract surgery.
• To highlight the cost-effectiveness, simplicity, and time-saving benefits of using a phaco-probe.

Main Methods:

• Two cases of complicated cataract surgery with nucleus drop into the vitreous cavity were analyzed.
• The phaco-probe's sleeve was removed, and infusion was disconnected to adapt it for use as a fragmatome.
• The technique's performance was compared to traditional fragmatome use.

Main Results:

• The phaco-probe demonstrated reduced lenticular repulsion compared to a fragmatome.
• No scleral burns were observed during the procedure.
• Both cases were successfully managed with secondary intra-ocular lens implantation in the sulcus during the same surgical session.

Conclusions:

• The phaco-probe is a viable and effective alternative for managing nucleus drop in the absence of a fragmatome.
• This method provides a cost-effective, simple, and time-efficient solution for a dreaded surgical complication.