Supplementary Material for: A 27-gauge Light Pipe-assisted Modified Kebab Technique for Safe Retrieval of a Dropped Lens Nucleus: A Case Report

Introduction: Management of dropped lens nuclei can be challenging, and several approaches have been reported, including perfluorocarbon liquid (PFCL) flotation and the kebab technique with intraocular diathermy. However, these approaches require dedicated instruments and may involve risks such as residual PFCL retention, thermal injury, or increased cost. This study presents a case of modified kebab technique using a 27-gauge illuminated light pipe to safely retrieve a dropped lens nucleus, without requiring the use of PFCL or diathermy.
Case Presentation: A patient who experienced a posterior capsule rupture with a dropped nucleus during cataract surgery subsequently underwent pars plana vitrectomy using a 27-gauge three-port system on the following day. After core vitrectomy and removal of the vitreous surrounding the dropped nucleus, the nucleus was gently brought closer using suction from the vitreous cutter. The tip of the 27-gauge light pipe was inserted into the nucleus, advanced to fully penetrate it, and used to establish firm fixation. The nucleus was then elevated into the anterior chamber and removed via phacoemulsification while being rotated. Postoperatively, no complications were observed, and the patient’s visual acuity improved from 20/100 (logMAR 0.7) to 20/20 (logMAR 0.0) at 1 month after surgery.
Conclusion: This modified kebab technique using a 27-gauge illuminated light pipe allows nucleus fixation and retrieval in selected cases, without the routine use of PFCL or diathermy. This simple technique may serve as a practical salvage option, particularly when dedicated instruments are unavailable.

引言：晶状体核脱落的处理颇具挑战，目前已有多种术式被报道，包括全氟碳液（perfluorocarbon liquid, PFCL）漂浮法及联合眼内透热的串烤固定技术（kebab technique）。然而，上述术式均需专用器械，且可能存在全氟碳液残留、热损伤或手术成本增加等风险。本研究报告1例采用27号照明光导纤维（illuminated light pipe）改良串烤固定技术的病例，可安全取出脱落的晶状体核，且无需使用全氟碳液或透热设备。

病例报告：1例患者在白内障手术中出现后囊膜破裂伴晶状体核脱落，术后次日接受了27号三端口系统经睫状体平坦部玻璃体切除术（pars plana vitrectomy）。术中先行核心玻璃体切除术，并清除脱落晶状体核周围的玻璃体，随后利用玻璃体切割头的抽吸装置将晶状体核轻轻向术野拉近。将27号照明光导纤维的尖端插入晶状体核，推进至完全穿透核组织，以此实现牢固固定。随后将晶状体核提拉至前房，边旋转边通过超声乳化术将其取出。术后1个月随访未见并发症，患者视力从20/100（对数最小分辨角logMAR 0.7）提升至20/20（logMAR 0.0）。

结论：本研究采用的27号照明光导纤维改良串烤固定技术，可在选定病例中实现晶状体核的固定与取出，且无需常规使用全氟碳液或透热设备。该术式操作简便，可作为实用的补救方案，尤其适用于无法获取专用器械的临床场景。