Trishool The Triple Edge Wedge Tool: A Modified Classical Simple Machine To Crack And Break The Hard Cataract

Is to describe an efficient and safe device Trishool the wedge tool designed with the principle of classical simple machine and Griffith’s theory of brittle fracture to crack and break the mature hard cataract into full thickness free segments including the posterior plate with much ease and which is also free from high intensity shock and strain

1000 cases of hard cataract of LOCS grade II to grade VI nucleus in our study. We found that trishool the triple edge wedge tool was highly efficient, safe and simple to crack and break these hard nuclei into multiple free segments. Surgery was conducted successfully in all the 1000 eyes. Full thickness cracking was possible in 99.1% of cases. 0.9 % of cases nucleus was removed in total with ECCE technique. In one case PCR due to excessive stress force directed posteriorly.

We incorporated triangular wedge design into the tip of the terminator in which pointed apex of wedge is kept at the inner edge of the tip while wide and flat base of wedge is placed at the posterior surface of the tip. Simply drawing the wedge inner edge of the terminator through the equator of the nucleus after hooking it around generate transversal fracture force with amplification, induce full thickness nuclear crack which automatically traverses through the entire nucleus breaking it into two complete free segments. Emulsification of full thickness free segments makes surgical maneuvers much easier and facilitates the overall procedure with higher level of efficiency and safety.

Wedges have been successfully used in rock excavation system since the ancient time to crack and break solid hard rocks. We used terminator the wedge tool in 1000 cases of hard cataract of LOCS grade II to grade VI nucleus in our study. We found that terminator the wedge tool was highly efficient, safe and simple to crack and break these hard nuclei into multiple free segments. Surgery was conducted successfully in all the 1000 eyes. Full thickness cracking was possible in 99.1% of cases. 0.9 % of cases nucleus was removed in total with ECCE technique. In one case PCR due to excessive stress force directed posteriorly. Cornea was clear in 98.2% of cases on first postoperative

Trishool the triple edge wedge tool is the simplest of tools, with its unique physical property, enables us to crack and break the hardest of hard cataract with very little effort and much easier surgical manoeuvre. Nuclear cracking is highly efficient, least traumatic giving minimal stress on the zonule's and posterior capsule.