Prof. Dr.RAJESH GANESUNI

Abstract

HARD CATARACT IS FACED BY SURGERONS EVERY DAY IN SURGERY. IT IS ALWAYS VERY DIFFICULT TRYING TO MANAGE THESE HARD CATARACTS AND PARTICULARLY WHEN TRYING TO BREAK THE NUCLEUS INTO NUMBER OF PIECES. SOMETIMES THE POSTERIOR PLATE OF THE NUCLEUS MAY BE VERY HARD OR LEATHERY AND WHILE USING DIFFERENT MANOEVOURS AND CHOPPING TECHNIQUES, THERE IS A RISK OF CAUSING A POSTERIOR CAPSULE RENT AND ZONULAR DIALYSIS. THE SOLUTION TO THIS IS TO HAVE ACCESS OF THE POSTERIOR PLATE DIRECTLY TO THE PHACO TIP. THIS CAN BE ACHIEVED BY FLIPPING THE NUCLUES 180 DEGREES – “SOMERSAULT”. THIS CAN BE DONE IN ALL GRADES OF CATARACTS FOLLOWING THE GUIDELINES AND IS FOUND. BE VERY USEFUL IN THE HARD CATARACTS. COMBINING “SOMERSAULT PHACO” WITH OTHER INNOVATIONS LIKE 'NINZA CHOP', ' SINGLE HAND PHACO' CAN BE ACHIEVED EFFICIENTLY. THE EFFECTIVE PHACO TIME AND THE EFFECTIVE PHACO ENERY USED IS LESS WITH THIS TECHNIQUE COMPARED TO OTHER TECHNIQUES FOR SIMILAR GRADE OF CATARACT.