Discussion on nucleus expression in SICS
Wire Vectis vs Irrigating Vectis.
Anyone trained at Aravind Eye Hospitals will be quiet comfortable with Irrigating Vectis.
Some argue that irrigating Vectis results in flat chamber and pupillary miosis.
That may be true in unskilled hands.
Irrigating Vectis is held in the right hand.
Some hold superior rectus in the left hand.
Some hold Limbs in the left hand.
The Limbs forceps is a tool to fixate the globe for counter traction.
The globe is held either at 6 o clock or at the edge of the tunnel.
Many surgeons consider putting bridle suture in private practice to be an absolute blasphemy.
The classic technique in expression with irrigating Vectis revolves around three events happening near simultaneously:
- Saline Irrigation from the pores of irrigating Vectis.
- Pulling of the Vectis towards the stomach
- Little posterior pressure depressing the tunnel floor
Many surgeons are against irrigating Vectis as they believe it results in significant volumetric and barometric fluctuations in the anterior chamber.
In the opinion of Dr. Arup Chakravarty, he has tried all techniques of nucleus expression (excluding the snare) and calibrated the corneal clarity with each one of them.
The irrigating Vectis technique reigned supreme.
Sandwich and phaco section techniques are great too.