Phacoemulsification in Cases of Zonular Weakness Using In Situ Nuclear Disassembly without Nuclear Rotation

Authors

1 Professor of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

2 Lecturer of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

3 MSc of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Due to zonular dehiscence or weakness, cataract surgery may result in late intraocular lens subluxation or dislocation, vitreous loss, dropped nuclei fragments, or all of these complications. Aim of the work: The objective of this study is to evaluate the occurrence and intensity of intraoperative problems in pseudoexfoliation (PEX) cases when employing in situ nuclear disassembly without nuclear rotation. Patients and methods: On 100 eyes of 100 cases with zonular weakness, this prospective, interventional, comparative study was carried out. Fifty patients undergoing phacoemulsification with in situ nuclear disassembly and the other 50 patients undergoing conventional chopping technique whom were admitted to the Ophthalmology Department, Faculty of Medicine, Al-Azhar University and carried out in Al-Hussein University Hospital. Results: There weren't any statistically significant differences in age or sex observed between the two groups. Regarding type of weakness, 50 cases was PXE and 50 cases was senile weakness over 70 years. Time of surgery was 15.02 ± 2.83 minutes in cases undergoing in situ nuclear disassembly and 19.9 ± 2.75 minutes in cases undergoing conventional method, indicating a large and significant difference between the two groups. Conclusion: The utilization of the Kelman type phaco tip allows for the execution of lateral sweep sculpting and in situ cracking techniques in cases where there is a presence of weak zonules and zonular weakness. This facilitates the safe and efficient performance of phacoemulsification procedures without the need for nuclear rotation..

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