Phacoemulsification: Small Fragments

  • Rajen Gupta


After hydrodissection, the lens nucleus is ready for removal. The whole lens, however, is too large to be expressed through the capsulorhexis opening. To avoid over-stretching and tearing the capsulorhexis, the lens must be divided into smaller sized pieces. Each fragment must be sized for safe extraction from the bag in preparation for subsequent phacoemulsification. Dexterity, of both hands and feet, is required during phacoemulsification of the lens nucleus. And continuous decision-making is necessary to decide how best to achieve lens disassembly. Although there are a plethora of phacoemulsification techniques described, the aim, simply put, is to develop the skills of the ‘lazy phaco surgeon’—that is, to learn how to do as little as possible to achieve lens extraction from the eye.

Supplementary material

Video 8.1

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Video 8.2

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Video 8.3

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  1. 1.
    McAlister C. Breaking the silence of the switch—increasing transparency about trainee participation in surgery. N Engl J Med. 2015;372:2477–9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Rajen Gupta
    • 1
  1. 1.Newcastle Eye Centre Royal Victoria InfirmaryNewcastle upon TyneUK

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