June 30, 2015
Modern-day cataract surgery requires lysis of most, if not all, corticocapsular adhesions toward the outer lens surface and freeing cortical-nuclear attachments in the interior of the cataractous lens. Hydrodissection is utilized to shear corticocapsular adhesions, while hydrodelineation breaks the epinuclear-nuclear adhesions. These surgical steps will facilitate in-the-bag nuclear rotation, thus assisting in lens division and removal by the technique of the surgeon’s choice. Further, such separation of the cortex from the lens capsule will simplify cortical cleanup and help preserve an intact posterior lens capsule for in-the-bag IOL placement. Incomplete lysis of corticocapsular adhesions can impede effective nuclear rotation and may result in possible zonular stretch and/or zonular lysis that can compromise the capsule-zonular complex.