Forceps-guided nuclear cleavage cataract extraction

Abstract

We introduce a manual nuclear fragmentation technique, forceps-guided nuclear cleavage. A 5.5 to 7.0 mm superior scleral incision is started 1.5 mm posterior to the limbus. Two additional 1.0 mm paracenteses are made at 3 and 9 o’clock in clear cornea close to the limbus. A continuous curvilinear capsulorhexis (CCC) is created; in most cases, 4 to 5 radial relaxing incisions are made in the CCC. The anterior and equatorial cortex and epinucleus are removed with 2-handed irrigation/aspiration via the 2 paracenteses with the nucleus in the capsular bag. The nucleus is prolapsed into the anterior chamber. A nucleus hook is inserted via the 3 o’clock paracentesis and applied to the 6 o’clock nuclear equator to hold the nucleus. A nucleus cleaving forceps is inserted through the upper incision to the 12 o’clock equator of the nucleus and advanced to one-third depth of the nucleus. The forceps is relaxed while the nucleus is cleaved in half.