Cicumcorneal perilimbal topical anaesthesia for phacoemulsification

Evaluation of circumcorneal perilimbal topical anaesthesia applied by the surgeon just before the operation in a single dose regimen. This work included 30 eyes of 30 patients: all had phacoemulsification and IOL implantation. Topical anaesthesia was applied by the surgeon just before the operation. The tip of a sponge soaked in preservative free lidocaine hydrochloride 2% was applied with slight pressure to the entire circumcorneal perilimbal area for about 1 minute, no other anaesthetic drops or premedications were used. Twenty-two patients [73.3%] reported no pain during the operation. 6 patients reported mild pain. 2 patients reported moderate pain and no patient reported severe pain. This technique of anaesthesia was safe and effective for clear corneal phacoemulsification

Different techniques of nucleus delivery in extracapsular cataract extraction

This study aimed to evaluate different techniques performed for nucleus delivery in planned extracapsular cataract extraction [ECCE]. ECCE with or without posterior chamber IOL was performed in 60 eyes of 50 patients. Patients were divided into 3 groups according to the technique of nucleus delivery. Each group included 20 eyes. In the first group the nucleus was delivered by bimanual pressure at 6 o'clock and 12 o'clock. In the second group the nucleus was delivered by Simcoe loop and in the third group the nucleus was delivered by pressure on the sclera at 12 o'clock after closed hydrodissection technique. Nucleus delivery was classified into easy, difficult or failed when the surgeon shifted to another technique to deliver the nucleus. In the first group, difficult expression of lens nucleus occurred in 3 cases and failed expression in 3 cases. Zonular rupture and vitreous loss occured in 2 cases, we recommend to avoid this technique in cases with weak zonule and in cases with old age and high myopia. In the second group difficult nucleus delivery occurred in 4 cases. This technique needs more surgical skill and is better avoided in young patients. In the third group difficult nucleus delivery occurred in 3 cases and failed nucleus delivery in 3 cases. This technique must be avoided in Morgagnian cataract and in soft eyes