Abstract
Purpose
We put forward a physical levitation method to hook and flip the chopped nuclear fragments that could not be solely drawn by vacuum during phacoemulsification, due to various reasons such as a non-rotating nuclei or posterior polar cataracts where hydrodissection was unsuccessful or contra-indicated, respectively.
Method
A Sinskey hook is insinuated through the crack of the divided nuclei into a plane behind the nuclear pie to ‘hook and flip’ the chopped piece, heading it towards the phacoemulsification probe. This simple step disassembles the nuclear chunk, thereby creating space to facilitate the dismantling of the rest of the fragments. The remnant epinuclear cushion guards the posterior capsule, mitigating the chances of serious intra-operative complications.
Result
We have employed this technique in 17 eyes during similar situations. No specific intra-operative complications were observed; all surgeries were uneventful. A Sinskey hook utilised for this step ensures safety and familiarity, none encountered posterior capsular rent. This technique not only eases the surgery, but also decreases the anticipated intra-operative and post-operative complications.
Conclusion
‘Hook and flip technique’ thus proves useful whenever dismantling difficulties are encountered during phacoemulsification.
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Acknowledgements
Mr Sanjay Sharma for his contribution in video editing and Mr Ramchandra B Pokale for image art.
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The procedures performed in this report involving human subject were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.
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Gupta, S., Selvan, H. & Khokhar, S. Hook and flip technique: for phacoemulsification in non-rotating nuclei and posterior polar cataracts. Int Ophthalmol 39, 1219–1223 (2019). https://doi.org/10.1007/s10792-018-0928-9
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DOI: https://doi.org/10.1007/s10792-018-0928-9