Abstract
Background: 870 eyes of 855 patients with intumescent immature and total white cataract were enrolled in this retrospective clinical study (2013-2018). Methods: Through a side port using a 25 gauze round/flat tipped fine cannula connected to a 5ml syringe (after a nick being created by a regular 26 gauze cystitome) the free capsular flap was vacuumed by the tip of the 25 gauge cannula and suction pressure created by withdrawing the piston of the syringe and a controlled motion done to create a circular rhexis, without withdrawing the instrument from anterior chamber and aspirating liquefied cortex by the same cannula. All cases were done under peribulbar anesthesia. Results: A complete cannula vacuum continuous curvilinear capsulorhexis (CanVac-CCC) was achieved in 860 cases (98.85%) except eight cases (0.91%) which had anterior capsular rhexis extension and two cases (0.22%) which had also extended posterior capsular tear. Conclusion: Performing CanVac -CCC with our technique is safe and affordable and may be an alternative promising method to routine CCC by using 26 gauge cystitome, Utrata or microrhexis forceps.
Highlights
Continuous curvilinear capsulorhexis is extremely important for a safe phacoemulsification and in the bag implantation of intra ocular lens
We describe a new technique using manual cannula rhexis which requires a simple 25 gauge rounded/flat tipped fine cannula connected to a 5ml syringehalf filled with balanced salt solution
The double, triple rhexis and partial enlargement of rhexis was done using Utrata or microrhexis forceps after the primary rhexis being completed by CavVac
Summary
Continuous curvilinear capsulorhexis is extremely important for a safe phacoemulsification and in the bag implantation of intra ocular lens. Patients included all intumescent cataract (white mature and immature cataract with ratio of 608:162 eyes) and cannula vacuum continuous curvilinear capsulorhexis (Can Vac-CCC) was done in all. Methods: Through a side port using a gauze round/flat tipped fine cannula connected to a 5ml syringe (after a nick being created by a regular gauze cystitome) the free capsular flap was vacuumed by the tip of the 25 gauge cannula and suction pressure created by withdrawing the piston of the syringe and a controlled motion done to create a circular rhexis, without withdrawing the instrument from anterior chamber and aspirating liquefied cortex by the same cannula. Results: A complete cannula vacuum continuous curvilinear capsulorhexis (CanVac-CCC) was achieved in 860 cases (98.85%) except eight cases (0.91%) which had anterior capsular rhexis extension and two cases (0.22%) which had extended posterior capsular tear. Conclusion: Performing CanVac -CCC with our technique is safe and affordable and may be an alternative promising method to routine CCC by using 26 gauge cystitome, Utrata or microrhexis forceps.
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