[Viscosurgically assisted hydro-jet irrigation of the lens nucleus. An effective procedure for extracapsular cataract extraction with capsulorhesis].

BACKGROUND

To reduce costs and to be independent of high technology equipment it is desirable to perform cataract operations of high quality manually.

MATERIALS AND METHODS

The manual operation includes a spiral shaped capsulorhexis, hydrodissection of the nucleous and its consequent delamination by means of hydroxypropylmethylcellulose (Metho). A bent cannula is used to create a jet stream of fluid separating the nucleous from the cortex and pressing the nucleous out of the bag. The cannula is connected to an infusion system 80 cm above the patient's eye. The nucleous slips into the anterior chamber and is delivered by injection of Metho, the injection cannula acts as a spatula to facilitate nucleous delivery. The nucleous also can be fragmentated for reduced incision length. The method was combined with an 8 mm tunnel incision. The implanted lenses had 7 mm optics and 10 or 11 mm haptics. In 100 consecutive operations (48 in males and 52 in females respectively) daily clinical examination was carried out for 7 days including the day of operation. Complications occurring during this time were listed.

RESULTS

No lesion of the capsule/zonule diaphragm occurred. In 3 cases corneal edema was observed, which disappeared within 5 days totally. In 2 cases a continuous rhexis was not achieved, but the lens was situated in the bag and centered well in these cases as well as in the 98 eyes with intact capsulorhexis.

CONCLUSIONS

The method described is safe. Using a purely manual operation technique it is possible to achieve an excellent lens fixation in the bag with undamaged rehexis rim and scleral tunnel incision.