2987: MSICS: split the nucleus prior to removal
In manual small incision cataract surgery, splitting the lens nucleus in half prior to extraction allows for a significantly smaller scleral tunnel incision. This internal fracture technique is helpful when dealing with an advanced, denser cataract that is larger in overall physical dimensions. Rather than extending the main incision to accommodate a massive nucleus, bisecting the structure allows each half to be extracted sequentially with less mechanical stress on the wound architecture. This approach preserves the self sealing nature of the scleral tunnel, reduces postoperative astigmatism, and ensures a faster visual recovery for the patient. Watch the precise instrument coordination required to cleanly divide this firm nucleus within the anterior chamber before safely delivering the segments. What instrument or technique do you prefer for splitting a dense lens during small incision surgery? Please comment your thoughts and preferred approaches below.
