Back to Journals » Clinical Ophthalmology » Volume 13

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

DOI https://doi.org/10.2147/OPTH.S197359

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

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

Views: 1839

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

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]