Nucleus Division Without Rotation: Umbrella Technique
Narrative Responses:
Purpose
To describe a technique for nucleus division without rotating crystalline lens during phacoemulsification: Umbrella technique.
Methods
Between November 2012 and April 2013, 43 eyes were treated by phacoemulsification using umbrella technique.
After continuous curvilinear capsulotomy, the upper portion of the nucleus removed semicircular shape and longitudinal trench was made in the lower portion of the nucleus like umbrella shape. Dividing lower nucleus by the tip of the phaco hand piece and chopper, nucleus divided into longitudinally. Vertical divide made on the both sides of remaining lens. Lens was divided into four quadrants without rotating the crystalline lens.
We compared 43 eyes that underwent this technique with 40 eyes conventional divide and conquer technique at postop 3 months.
Results
The rate of complete division in to four quadrants without rotating nucleus were 90.7% (39 eyes). By slightly lifting the bottom of both sides of the vertical trench upward ,the rate of complete division increased to 100%: The shape of the 45 degrees Kelman tip is suitable for this technique. Complete hydrodissection is not necessary. No difference was seen in the visual recovery and mean corneal endothelial cell loss between the two groups.
Conclusion
This technique of nucleus division without rotating the crystalline lens minimizes the load to the Zinn zonule and prevents its iatrogenic dissection. It is useful for cases with weak zonules.