Phacoemulsification With Hydrodelineation And Ovd-Assisted Hydrodissection In Soft Cataracts: Very Safe And Quick Procedure.

To evaluate the safety and efficiency of innovative technique of performing  hydrodelineation for phacoemulsification of  nucleus and OVD-assisted [Ophthalmic Viscosurgical Devices] hydrodissection for aspiration of epinucleus in management of soft cataracts.

Setting: Tertiary care Centre, Cataract and Refractive Services of Advanced Eye Centre, PGIMER, Chandigarh, INDIA

Medical records of 22 eyes from 22 patients with clinical diagnosis of soft cataract [LOCS < 2 ], who underwent phacoemulsification with hydrodelineation and OVD-assisted(2% hydroxy-propyl methylcellulose [HPMC]) hydrodissection, were reviewed. Centurion Phacoemulsification system (Alcon Laboratories, Inc.) with active fluidics and active sentry hand piece was used with vacuum parameters of 80 to 575 mm Hg and an aspiration flow rate of 12–45 mL/min, all  in linear mode. The primary outcome measures were cumulative dissipated energy (CDE), ultrasound time (UST), amount of fluid used, surgical complication of posterior capsular tear.

All cases were completed successfully with IOL implantation in the bag and without any complication of posterior capsular tear. Mean CDE, total UST and total estimated fluid aspirated was:  1.12 ± 1.38, 8.88 ± 9.52 sec and 72.05 ± 26.52 ml respectively

Phacoemulsification with hydrodelineation and OVD-assisted hydrodissection  in soft cataracts is a non fragmentation/ non- chopping  technique, without use of any sharp instruments. Leaving  epinuclear shell during phacoemulsification of nucleus as well as OVD assisted hydrodissection  of epinucleus protects posterior capsule. It is in the bag phacoemulsification with minimal USG energy which may protect the endothelium better. It is a simple, safe, faster, surgeon friendly technique for soft to mildly denser cataracts and can be practised by novice surgeon.