Purchase this article with an account.
Y. Mizushima, T. Oshika, F. Yoshitomi; Double-Arm Hook (Cobra Hook) to Protect Corneal Endothelial Cells During Phacoemulsification. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1082.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
In order to protect corneal endothelial cells during phacoemulsification and aspiration (PEA) by preventing direct contact of nuclear pieces with the endothelium, we developed a new nucleus manipulating hook having double arms in the shaft, cobra hook.
48 eyes of 24 patients with cataract in both eyes (mean age; 74.5±8.4) were included. The degree of nucleus color was grade 4 or higher bilaterally on the lens opacities classification system III (LOCS III), and the grade of each eye did not differ by 2 grades or more. One surgeon performed PEA and intraocular lens implantation on both eyes within one week interval. The chopper type cobra hook was used for one eye chosen randomly, and the normal phaco chopper was used for the other eye. All eyes were operated on by the phaco chop nuclear division technique using the soft-shell technique. Corneal endothelial density was assessed before and one month after operation.
The LOCS III grade for nuclear color was 4.6 ± 0.6 in the cobra hook group, and 4.7 ± 0.7 in the control group. The rate of endothelial cell loss was 3.1 ± 9.9% and 13.7 ± 18.4%, in the cobra hook and control groups, respectively. There was significant difference between groups (p<0.01, paired t-test). In all cases, there was no complication during operation.
The cobra hook effectively protected corneal endothelial cells by preventing nuclear pieces from contacting directly during cataract surgery.
This PDF is available to Subscribers Only