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A Novel Inexpensive Rhexis Technique-Can Vac Ccc for Immature and White Intumescent Cataract - Our Experience

Received: 21 January 2020     Accepted: 10 April 2020     Published: 28 April 2020
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Abstract

Background: 870 eyes of 855 patients with intumescent immature and total white cataract were enrolled in this retrospective clinical study (2013-2018). Methods: Through a side port using a 25 gauze round/flat tipped fine cannula connected to a 5ml syringe (after a nick being created by a regular 26 gauze cystitome) the free capsular flap was vacuumed by the tip of the 25 gauge cannula and suction pressure created by withdrawing the piston of the syringe and a controlled motion done to create a circular rhexis, without withdrawing the instrument from anterior chamber and aspirating liquefied cortex by the same cannula. All cases were done under peribulbar anesthesia. Results: A complete cannula vacuum continuous curvilinear capsulorhexis (CanVac-CCC) was achieved in 860 cases (98.85%) except eight cases (0.91%) which had anterior capsular rhexis extension and two cases (0.22%) which had also extended posterior capsular tear. Conclusion: Performing CanVac -CCC with our technique is safe and affordable and may be an alternative promising method to routine CCC by using 26 gauge cystitome, Utrata or microrhexis forceps.

Published in International Journal of Ophthalmology & Visual Science (Volume 5, Issue 2)
DOI 10.11648/j.ijovs.20200502.13
Page(s) 53-56
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Intumescent, Capsulorhexis, Cannula, Vacuum

References
[1] Figueiredo CG, Figueiredo J, Figueiredo GB. Brazilian technique for prevention of the Argentinean flag sign in white cataract. J Cataract Refract Surg. 2012 Sep; 38 (9): 1531–6.
[2] Gavriș M, Mateescu R, Belicioiu R, Olteanu I. Is Laser Assisted Capsulotomy better than standard CCC? Romanian J Ophthalmol. 2017 Mar; 61 (1): 18–22.
[3] Pandey SK, Sharma V. Zepto-rhexis: A new surgical technique of capsulorhexis using precision nano-pulse technology in difficult cataract cases. Indian J Ophthalmol. 2018; 66 (8): 1165–8.
[4] Oksuz H, Daglioglu MC, Coskun M, Ilhan O, Tuzcu EA, Ilhan N, et al. Vacuum-assisted continuous circular capsulorhexis using bimanual irrigation and aspiration system of phaco machine in immature cataract. J Ophthalmol. 2013; Article ID 921646.
[5] Coelho RP, Martin LF, Paula JS, Scott IU. Comparison of preoperative Nd: YAG laser anterior capsulotomy versus two-stage curvilinear capsulorhexis in phacoemulsification of white intumescent cataracts. Ophthalmic Surg Lasers Imaging 2009; 40: 582-5.
[6] Richards JC, Harrison DC. Preoperative neodymium: YAG anterior capsulotomy in intumescent cataract: Preventing extension of the capsular tear to the lens periphery. J Cataract Refract Surg 2003; 29: 1630-1.
[7] Zhang G, Bao Y, Qiu K, Zao J. Phacoemulsification in white cataract. Yan Ke Xue Bao. 2000; 16: 252–3. 258.
[8] Figueiredo CG, Figueiredo J, Figueiredo GB. Brazilian technique for prevention of the Argentinean flag sign in white cataract. J Cataract Refract Surg 2013; 39: 307
[9] Bhattacharjee K, Bhattacharjee H, Goswami BJ, Sarma P. Capsulorhexis in intumescent cataract. J Cataract Refract Surg 1999; 25: 1045-7.
[10] Brazitikos PD, Tsinopoulos IT, Papadopoulos NT, Fotiadis K, Stangos NT. Ultrasonographic classification and phacoemulsification of white senile cataracts. Ophthalmology 1999; 106: 2178-8
[11] Ermiss SS, Ozturk F, Inan UU. Comparing the efficacy and safety of phacoemulsification in white mature and other types of senile cataracts. Br J Ophthalmol. 2003; 87: 1356–9.
[12] Chan DD, Ng AC, Leung CK, Tse RK. Continuous curvilinear capsulorhexis in intumescent or hypermature cataract with liquefied cortex. J Cataract Refract Surg. 2003; 29: 431–34.
[13] Vajpayee RB, Bansal A, Sharma N, Dada T, Dada VK. Phacoemulsification of white hypermature cataract. J Cataract Refract Surg. 1999; 25: 1157–60.
[14] Rao SK, Padmanabhan P. Capsulorhexis in white cataracts. J Cataract Refract Surg 2000; 26: 477-8.
[15] Brusini P. Use of air in phacoemulsification of mature cataract. J Cataract Refract Surg 1998; 24: 874-5.
[16] Perrone D, Albertazzi R (2009) “Argentina Flag Sign”, Video J Cataract Refract Surg Clinics (Sao Paulo). 64 (4): 309-312.
[17] Titiyal JS, Kaur M, Singh A, Arora T, Sharma N (2016) Comparative evaluation of femtosecond laser-assisted cataract surgery and conventional phacoemulsification in white cataract. Clin Ophthalmol 10: 1357-1364.
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  • APA Style

    Shreesha Kumar Kodavoor, Bijita Deb, Dandapani Ramamurthy. (2020). A Novel Inexpensive Rhexis Technique-Can Vac Ccc for Immature and White Intumescent Cataract - Our Experience. International Journal of Ophthalmology & Visual Science, 5(2), 53-56. https://doi.org/10.11648/j.ijovs.20200502.13

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    ACS Style

    Shreesha Kumar Kodavoor; Bijita Deb; Dandapani Ramamurthy. A Novel Inexpensive Rhexis Technique-Can Vac Ccc for Immature and White Intumescent Cataract - Our Experience. Int. J. Ophthalmol. Vis. Sci. 2020, 5(2), 53-56. doi: 10.11648/j.ijovs.20200502.13

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    AMA Style

    Shreesha Kumar Kodavoor, Bijita Deb, Dandapani Ramamurthy. A Novel Inexpensive Rhexis Technique-Can Vac Ccc for Immature and White Intumescent Cataract - Our Experience. Int J Ophthalmol Vis Sci. 2020;5(2):53-56. doi: 10.11648/j.ijovs.20200502.13

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  • @article{10.11648/j.ijovs.20200502.13,
      author = {Shreesha Kumar Kodavoor and Bijita Deb and Dandapani Ramamurthy},
      title = {A Novel Inexpensive Rhexis Technique-Can Vac Ccc for Immature and White Intumescent Cataract - Our Experience},
      journal = {International Journal of Ophthalmology & Visual Science},
      volume = {5},
      number = {2},
      pages = {53-56},
      doi = {10.11648/j.ijovs.20200502.13},
      url = {https://doi.org/10.11648/j.ijovs.20200502.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20200502.13},
      abstract = {Background: 870 eyes of 855 patients with intumescent immature and total white cataract were enrolled in this retrospective clinical study (2013-2018). Methods: Through a side port using a 25 gauze round/flat tipped fine cannula connected to a 5ml syringe (after a nick being created by a regular 26 gauze cystitome) the free capsular flap was vacuumed by the tip of the 25 gauge cannula and suction pressure created by withdrawing the piston of the syringe and a controlled motion done to create a circular rhexis, without withdrawing the instrument from anterior chamber and aspirating liquefied cortex by the same cannula. All cases were done under peribulbar anesthesia. Results: A complete cannula vacuum continuous curvilinear capsulorhexis (CanVac-CCC) was achieved in 860 cases (98.85%) except eight cases (0.91%) which had anterior capsular rhexis extension and two cases (0.22%) which had also extended posterior capsular tear. Conclusion: Performing CanVac -CCC with our technique is safe and affordable and may be an alternative promising method to routine CCC by using 26 gauge cystitome, Utrata or microrhexis forceps.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - A Novel Inexpensive Rhexis Technique-Can Vac Ccc for Immature and White Intumescent Cataract - Our Experience
    AU  - Shreesha Kumar Kodavoor
    AU  - Bijita Deb
    AU  - Dandapani Ramamurthy
    Y1  - 2020/04/28
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    DO  - 10.11648/j.ijovs.20200502.13
    T2  - International Journal of Ophthalmology & Visual Science
    JF  - International Journal of Ophthalmology & Visual Science
    JO  - International Journal of Ophthalmology & Visual Science
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    EP  - 56
    PB  - Science Publishing Group
    SN  - 2637-3858
    UR  - https://doi.org/10.11648/j.ijovs.20200502.13
    AB  - Background: 870 eyes of 855 patients with intumescent immature and total white cataract were enrolled in this retrospective clinical study (2013-2018). Methods: Through a side port using a 25 gauze round/flat tipped fine cannula connected to a 5ml syringe (after a nick being created by a regular 26 gauze cystitome) the free capsular flap was vacuumed by the tip of the 25 gauge cannula and suction pressure created by withdrawing the piston of the syringe and a controlled motion done to create a circular rhexis, without withdrawing the instrument from anterior chamber and aspirating liquefied cortex by the same cannula. All cases were done under peribulbar anesthesia. Results: A complete cannula vacuum continuous curvilinear capsulorhexis (CanVac-CCC) was achieved in 860 cases (98.85%) except eight cases (0.91%) which had anterior capsular rhexis extension and two cases (0.22%) which had also extended posterior capsular tear. Conclusion: Performing CanVac -CCC with our technique is safe and affordable and may be an alternative promising method to routine CCC by using 26 gauge cystitome, Utrata or microrhexis forceps.
    VL  - 5
    IS  - 2
    ER  - 

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Author Information
  • Department of Cornea, Cataract and Refractive Services, The Eye Foundation, Coimbatore, India

  • Department of Cornea, Cataract and Refractive Services, The Eye Foundation, Coimbatore, India

  • Department of Cataract and Refractive Services, The Eye Foundation, Coimbatore, India

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