title: Phacoemulsification in cases of pseudoexfoliation using in situ nuclear disassembly without nuclear rotation.
abstract: OBJECTIVE
  The purpose was to assess the safety and frequency of intraoperative complications of phacoemulsification using an in situ nuclear disassembly technique in pseudoexfoliation (PEX) cases.
  
  
  METHODS
  The work was done in Rustaq Hospital, Rustaq, Sultanate of Oman.
  
  
  METHODS
  This prospective, interventional, noncomparative study included 103 cases of cataract with pseudoexfoliation that underwent phacoemulsification with in situ nuclear disassembly using Alcon Infinity machine with Ozil handpeice and Kelman-style 45° phacoemulsification tip.
  
  
  RESULTS
  Of the 103 cases, 55 males (53.4%) and 48 (46.6%) females, one case developed posterior capsular rupture, and four cases developed zonular dehiscence that was partial in three cases and >180° in one case only. The best corrected visual acuity (BCVA) 4 weeks postoperatively using logMAR notation was as follows: 66 cases (65.1%) had BCVA of 0.30 or better (logMAR notation), and 37 cases (35.9%) had BCVA of 0.48 or less.
  
  
  CONCLUSIONS
  Safe and efficient phacoemulsification without nuclear rotation could be achieved in cases pseudoexfoliation in which zonular weakness is a concern by utilizing the versatility of Kelman style phaco tip to do lateral sweep sculpting and in situ cracking techniques. It prevents zonular stress by avoiding manipulation or rotation of the nucleus in cases.
authors.affiliation: Department of Ophthalmology, Rustaq Hospital, Rustaq, Sultanate of Oman, and Department of Ophthalmic, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt.
authors.forename: Mohamed A E S
authors.initials: MA
authors.lastname: Mahdy