Manual-delineation and dissection technique for posterior polar cataract

Abstract

In posterior polar cataract (PPC), the posterior capsule is weak or dehiscent. This can lead to posterior capsular rent at any time during cataract surgery, leading to complications. Various techniques have been used to manage such cataracts, and modifications are advised at each and every step of cataract surgery. We describe a new technique in which a blunt chopper is used to manually delineate the epinucleus from the nucleus at 360 degrees, and the nucleus is chopped and removed by phacoemulsification. Then, the chopper is inserted in the plane between the capsule and the epinucleus, and manual dissection is performed, followed by rotation and pushing it centrally. This epinucleus that is separated is aspirated simultaneously. Thus, with no pressure fluctuations and undue stress on the posterior capsule from the fluid jets, we manage to do surgery in tricky cases of PPCs successfully using manual delineation and dissection.