When we break the cataract nucleus into smaller fragments, we can sometimes have one of these small pieces stuck in the angle of the eye. We have previously shown that the safest maneuver is to take the probe out of the eye and use a stream of balanced salt solution to dislodge this piece for easier aspiration from the eye. Remember that partially withdrawing the phaco probe from the eye runs the risk of losing infusion, so that must be avoided.
We can either use the phaco probe or the I/A probe to remove this last nuclear piece. The main deciding factors are the size of the piece and its relative density. Larger and denser pieces are best removed with the phaco probe, while smaller and softer pieces can be removed using the I/A probe and a second instrument.
Click below to see the two different approaches to removing the last nuclear piece: