Phaco-handpiece used as a Fragmatome for managing nucleus drop

BACKGROUND: Nucleus drop during cataract surgery is a dreaded complication and requires urgent vitreo-retinal intervention which is managed commonly using a fragmatome. However, a fragmatome is not readily available in routine ophthalmology set-ups because its use is very limited. On the other hand, a phaco-probe is commonly available with all surgeons and makes it cost-effective. PURPOSE: The purpose is to demonstrate the utility of a phaco-probe as an alternative to a fragmatome in managing nucleus drop during cataract surgery, making it cost-effective and less time-consuming and simple. SYNOPSIS: The video shows two cases of complicated cataract surgery in which a nucleus is dropped in the vitreous cavity. The sleeve of the phaco-probe was removed, and infusion was disconnected to make it function as a fragmatome. We noted reduced lenticular repulsion from the phaco-handpiece tip as compared to the fragmatome, and no scleral burns were observed. The cases were completed by secondary placement of an intra-ocular lens in the sulcus in the same sitting. Thus, the phaco-probe can be considered to manage nucleus drop in the absence of a fragmatome. HIGHLIGHTS: A phaco-probe can be used as an alternative to a framgamtome, which is a cost-effective and simple technique. VIDEO LINK: https://youtu.be/6c-40Bcijrc