Comparing the number of attempts required for complete nuclear chop using calibrated and conventional phacotip

Background: Phacoemulsification is a state of art technique with a steep learning curve the configuration of the phacotip affects the efficacy and execution of the nuclear chopping techniques. Inadequate penetration of phacotip may result in partial thickness nuclear cleavage with residual posterior plane and over enthusiastic penetration may result in posterior capsule rupture. This may be avoided if some estimate can be made preoperatively of the depth of penetration required to achieve full thickness crack.Methods: A total of 60 eyes of 60 patients with age related cataract with grade 4.0 to 6.9 (LOCS III) fulfilling the inclusion and exclusion criteria were included in the study after written informed consent. They were divided into two groups A and B with 30 patients each randomly using envelope method and were operated using conventional and calibrated phacotips respectively and the number of attempts required to achieve complete nuclear chop was noted.Results: In group A, vertical chop was safely and effectively done is 23 patients in just one attempt while it took 2 attempts in 6 patients and 3 attempts in 1 patient. In group B, it took just one attempt in 26 patients while 2 attempts were required in 4 patients. The two groups were comparable (p value 0.453) and was found to be statistically significant.Conclusions: With the use of a calibrated phacotip, the surgeon already knows to what depth he has to penetrate the tip into the center of nucleus depending upon the grade of cataract which results in safe and effective chop in minimum attempts where as in the conventional phacotip, it is more of a blind process. Hence the calibrated phacotip has taken the guess work out of question.

Congenital generalized lipodystrophy of Berardinelli-Seip type: A rare case.

Congenital generalized lipodystrophy of Berardinelli-Seip type is a rare autosomal recessive disorder characterized by nearly complete absence of adipose tissue and a consequent generalized muscular appearance, which is recognized easily at birth. The condition is associated with various dermatological and systemic manifestations. We report a case of this form of lipodystrophy. The patient had several cutaneous manifestations, including severe acanthosis nigricans, generalized hyperpigmentation, curly scalp hair, prominent subcutaneous veins, and enlarged clitoris. She also had associated celiac disease.