A 27-Gauge Light Pipe-Assisted Modified Kebab Technique for Safe Retrieval of a Dropped Lens Nucleus: A Case Report

Management of dropped lens nuclei can be challenging, and several approaches have been reported, including perfluorocarbon liquid (PFCL) flotation and the kebab technique with intraocular diathermy. However, these approaches require dedicated instruments and may involve risks such as residual PFCL retention, thermal injury, or increased cost. This study presents a case of modified kebab technique using a 27-gauge illuminated light pipe to safely retrieve a dropped lens nucleus, without requiring the use of PFCL or diathermy.

A patient who experienced a posterior capsule rupture with a dropped nucleus during cataract surgery subsequently underwent pars plana vitrectomy using a 27-gauge three-port system on the following day. After core vitrectomy and removal of the vitreous surrounding the dropped nucleus, the nucleus was gently brought closer using suction from the vitreous cutter. The tip of the 27-gauge light pipe was inserted into the nucleus, advanced to fully penetrate it, and used to establish firm fixation. The nucleus was then elevated into the anterior chamber and removed via phacoemulsification while being rotated. Postoperatively, no complications were observed, and the patient's visual acuity improved from 20/100 (logMAR 0.7) to 20/20 (logMAR 0.0) at 1 month after surgery.

This modified kebab technique using a 27-gauge illuminated light pipe allows nucleus fixation and retrieval in selected cases, without the routine use of PFCL or diathermy. This simple technique may serve as a practical salvage option, particularly when dedicated instruments are unavailable.