If your incision has bad construction, try again

As you are making your phaco incision, judge the architecture and if it is not good, then stop and do not penetrate Descemet’s layer and do not enter the anterior chamber. You can abandon this poor incision, shift to a different position, and try again. A good incision is critical for surgical success during cataract surgery.

We have covered the topic of how to make a good phaco incision here, here, and here. And we have used our intra-operative OCT scan to carefully examine these incisions to differentiate good versus bad architecture.

When we look at the OCT scan, we can see that the poor incision has a very thin roof, but fortunately it does not penetrate the cornea fully. The new incision, shifted a clock hour away, has a proper architecture and good balance.

Click below to see the difference between these incisions (in the same eye):


  1. Hello, Doctor Devgan
    Thanks for all your beautiful videos.
    I also had a Corneal Main incision rip due to the phaco burn. Very similar to that you showed.
    I solved with a nylon 10.0 suture in “X”
    It worked ok for my patient.

Leave a Reply