This is a very subtle sign — looking at this title pic, we see a demarcation line just inside the iris edge. The anterior chamber was filled completely with dispersive viscoelastic using our method of performing a fluid exchange with the OVD wave. This fills the AC entirely with dispersive OVD and leaves it at a physiologic pressure in preparation for making the main phaco incision. Once we make the incision and start the capsulorhexis, we notice that the cataract moves slightly posterior and the AC deepens. This allows the little bit of residual aqueous that was in the posterior chamber behind the iris, to come forwards. And this is what we see at the tips of the blue arrows in this title photo.
This is a subtle, but critical sign, that you need to be able to recognize. You won’t find this in a textbook! I am committed to teaching the world all of the surgical pearls, tricks, and techniques that I have learned over the past 20+ years!
click below to learn this subtle sign indicating weak zonular support: