Remote hydrodissection

Abstract

We describe a technique for performing hydrodissection in which the cannula tip is not advanced beyond the capsulorhexis edge, nor embedded into the cortex, but instead is placed within the capsulorhexis boundaries, pointing to the capsulorhexis edge, and angled slightly posterior to it. The fluid stream squirted from the cannula creates a cleavage plane between the capsule and cortex (hydrodissection), with a distinct wave dissecting the posterior capsule off the overlying cortex. By later rotating the angle slightly more posteriorly, hydrodelineation occurs, with the resultant “golden ring,” and often, multiple “golden rings.” The cleavage planes obtained using this technique may be more precise than when embedding the cannula tip under and beyond the capsulorhexis edge. This “remote hydrodissection” technique is easy and reproducible with soft and medium lenses, becoming more difficult to perform with harder cataracts. Hence, we recommend that this modification should initially be learned/tried on softer lenses.