Channels: Cataract Surgery | Posted 12/3/2013
i have always used my second instrument to protect the capsule while removing the last bits of nuclear material. When Brian Little was a visiting professor here this winter he encouraged us to re think this concept. He pointed out how much fluid leaves the anterior chamber through the paracentesis around the second instrument. The fluid going to the paracentesis also disrupts the direct flow of fluid to the needle tip and set up fluid currents that can push bits of material away from the tip or to swirl in the chamber away from the needle.
As protecting the capsule was so engrained in my psyche I had a hard time even trying this. However we eventually did and i have so far at least found it to be very useful. The chamber is deeper without the second instrument as less fluid leaves the eye (through the paracentesis). As most all of the fluid leaving the eye is headed to the tip the nuclear bits tend to directly move to the tip without much effort.
Cataract • Cataract Surgery • Cataracts • Phacoemulsification