Aspiration Flow Rate should be high during final I/A

As we have learned from the phaco fundamentals videos / articles here on CataractCoach, setting the correct fluidic parameters is critical to success with phaco surgery. This is even important after the cataract has been removed and the new IOL has been implanted. This case shows that we found two cataract fragments, which were previously hidden, during our final I/A (irrigation/aspiration) to remove viscoelastic.

Using a flow of at least 50 cc/min (I use even higher) will help to flush out any remaining viscoelastic or lens fragments. Keeping in mind that the anterior chamber has a volume of about 0.25 cc (add a little more for the posterior chamber volume), and you can see that with a high flow rate, we washout the anterior segment very well and dozens of times in just a few seconds.

Remember this slide from the previous phaco fundamentals videos.

Click below to see how these lens fragments suddenly appeared during final I/A: