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A rapid technique for en masse soft cataract phacoemulsification

Authors Om Parkash R, Mahajan S, Om Parkash T, Vajpayee RB, Om Parkash T

Received 7 December 2018

Accepted for publication 5 March 2019

Published 26 April 2019 Volume 2019:13 Pages 755—762


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Supplementary video S1: This video demonstrates the RAPID technique in a stepwise manner. The nucleus is rotated (R) freely in the capsular bag from the side port incision by a second instrument. The phaco probe tip is partly aligned (A) sideways towards

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Rohit Om Parkash,1 Shruti Mahajan,1 Tushya Om Parkash,1 Rasik B Vajpayee,2 Tushar Om Parkash3

1Ophthalmology, Department of Cataract and Refractive Surgery, Dr Om Parkash Eye Institute, Amritsar, Punjab, India; 2Ophthalmology, FRCS, FRANZCO, Vision Eye Institute, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, VIC, Australia; 3Department of Ophthalmology, Vydehi Institute of Medical Sciences and Research, Bangalore, Karnataka, India

Purpose: To describe a new, en masse, stepwise technique for purely soft cataracts.
Methods: RAPID, a soft cataract phacoemulsification technique, is an acronym-based procedure where R is rotation of nucleus, A is alignment of phacoemulsification tip sideways, P is placement of tip adjacent to the nuclear rim, I is impaling of tip into nuclear rim and D is devouring wherein nucleus is aspirated/emulsified. RAPID technique was performed in 54 eyes of 54 patients (31 males and 23 females; mean age 46.35±3.95 years). The soft nucleus was emulsified, after performing hydrodissection, in a stepwise manner in the safe zone away from posterior capsule and corneal endothelium. Centurion/Infiniti Phacoemulsification system (Alcon Laboratories, Inc.) was used with vacuum parameters at 475 mm Hg and an aspiration flow rate of 0–45 mL/min in linear mode. The primary outcome measures were cumulative dissipated energy (CDE), ultrasound time (UST), amount of fluid used, surgical complications and mean endothelial cell loss.
Results: Phacoemulsification with IOL implantation was performed successfully in all patients without any intraoperative complications. CDE was 1.03±0.61. Total UST for nuclear emulsification was 3.84±3.27 seconds and fluid used was 10±2.35 milliliters. Postoperative follow-up examinations were done on 1, 4, 14, 30 and 90 days. Mean percentage of endothelial cell loss was 7.05±2.65% (mean endothelial cell counts were 2383.75±105.21 cells/mm2 preoperatively and 2215.78±114.9 cells/mm2 3 months postoperatively).
Conclusion: RAPID is an en masse non-fragmentation technique for purely soft cataracts. This technique requires neither any specialized instrumentations nor the use of high vacuum with complimenting surge preventing software. Simple stepwise multi-planer approach of RAPID technique allows easy and fast emulsification of soft cataracts with simultaneous safeguarding of posterior capsule and corneal endothelium.

Keywords: soft cataract phacoemulsification, RAPID en masse phacoemulsification technique, soft cataract

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