Nucleus viscoexpression compared with other techniques of nucleus removal in extracapsular cataract extraction with capsulorhexis.

We compared three nucleus delivery procedures used during extracapsular cataract extraction (ECCE) after capsulorhexis in 142 eyes. In 25 eyes, the nucleus was expressed through a capsulorhexis 7 mm or wider. In 40 eyes, the nucleus was broken into two pieces and removed through a capsulorhexis 6 mm or less. In 77 eyes, viscoexpression was used to remove the nucleus from the capsular bag through a capsulorhexis 6 mm or less. Nucleus expression after a wide capsulorhexis was successful in 68% of the eyes in which it was attempted. Nucleus fragmentation was successful in 90%. Postoperative inflammation was high in both of these groups. Nucleus viscoexpression was successful in 93%, with low postoperative inflammation. Although it requires a 7- to 8-millimeter corneoscleral incision, based on our study, viscoexpression would appear to be the best nuclear delivery technique when ECCE, rather than phacoemulsification, is being performed.