Hydro-delineate if the Capsulorhexis is too small

Hydro-delineation is a valuable tool particularly in cases where the capsulorhexis is small because it allows us to separate the endonucleus and remove it via this smaller opening. This case shows a patient with a posterior sub-capsular cataract but little nuclear sclerosis. This type of soft cataract makes chopping techniques more difficult and it is advantageous to bring the nucleus out of the capsular bag to be aspirated at the iris plane. But here we have a small capsulorhexis measuring about 4.5 mm in diameter. The solution here is to hydro-delineate to separate the endo-nucleus which can then be prolapsed out of the capsular bag. Care is taken to perform this technique gently to avoid over-pressurizing the capsular bag which could result in a blow-out of the posterior capsule.

Hydro-delineation is a useful technique for cataract surgery, particularly in situations where the capsulorhexis is somewhat smaller than desired.