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Abstract
BackgroundThe prerequisites for a good capsulorhexis include a deep, well maintained anterior chamber, globe stabilization and globe manipulation. This helps to achieve a capsulorhexis of optimal size, shape and obtain the best possible position for a red glow under retroillumination. We report the use of irrigation handpiece of bimanual irrigation aspiration system to stabilize the globe, maintain a deep anterior chamber and manipulate the globe to a position of optimal red reflex during needle capsulorhexis in phacoemulsification.MethodsTwo side ports are made with 20 G MVR 'V' lance knife (Alcon, USA). The irrigation handpiece with irrigation on is introduced into the anterior chamber through one side port and the 26-G cystitome (made from 26-G needle) is introduced through the other. The capsolurhexis is completed with the needle.ResultsNeedle capsulorhexis with this technique was used in 30 cases of uncomplicated immature senile cataracts. 10 cases were done under peribulbar anaesthesia and 20 under topical anaesthesia. A complete capsulorhexis was achieved in all cases.ConclusionThe irrigating handpiece maintains deep anterior chamber, stabilizes the globe, facilitates pupillary dilatation, and helps in maintaining the eye in the position with optimal red reflex during needle capsulorhexis. This technique is a safe and effective way to perform needle capsulorhexis.
Highlights
The prerequisites for a good capsulorhexis include a deep, well maintained anterior chamber, globe stabilization and globe manipulation
The needle capsulorhexis can be performed through side port incision using a viscoelastic device or an anterior chamber maintainer [1,2,4,5]
The cases with intumuscent cataracts, white cataracts, corneal opacities or other ocular pathologies were not included.10 cases were done under peribulbar anaesthesia and 20 under topical anaesthesia
Summary
The prerequisites for a good capsulorhexis include a deep, well maintained anterior chamber, globe stabilization and globe manipulation. This helps to achieve a capsulorhexis of optimal size, shape and obtain the best possible position for a red glow under retroillumination. We report the use of irrigation handpiece of bimanual irrigation aspiration system to stabilize the globe, maintain a deep anterior chamber and manipulate the globe to a position of optimal red reflex during needle capsulorhexis in phacoemulsification. During the performance of capsulorhexis, the globe can be stabilized either using a second instrument such as a Sinskey hook, or by holding limbal conjunctiva with a Lim's forceps. Holding conjunctiva with Lim's forceps can be traumatic or undesirable under topical anaesthesia
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