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Management of suprahard cataract with iris coloboma using snare

Poster Details

First Author: M.Khattri INDIA

Co Author(s):    M. Ghosh   V. Sahni   A. Gahlaut   M. Chaturvedi           

Abstract Details


Phacoemulsification is usually difficult in patients with very hard cataracts with associated iris coloboma owing to poorly dilated pupil, increased consumption of energy and risk of zonular dialysis while manipulating the nucleus.


Multicentric case series performed at Disha Eye Hospital, Kolkata, India


To perform safe surgery and yield clear cornea post operatively, we designed a technique of manual ‘small incision cataract surgery’ and nucleotomy using 36 gauge ‘snare’ followed by PCIOL implantation. We did conventional SICS (small incision cataract surgery). However after hydrodissection, we prolapsed the hard nucleus out of the bag and thereafter nucleotomy was done using snare. This helped to protect the cornea as well as helped to viscoexpress the pieces resulting in smaller incision with a sutureless closure.


Total 18 eyes were operated by this technique. None of them had PC rupture. All of them had minimal keratitis that resolved in a week’s time with topical prednisolone drops. One case had post op hyphaema for which AC wash had to be done.


By this technique, even the hardest of nuclei can be managed with clear post op cornea and the surgery still remains sutureless and relatively free of complications.

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