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Updated: Aug 21, 2026
Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries
Published on: July 7, 2023
Phaco rolling technique
Jose L Güell1, Mercedes Vázquez, Jose Lucena
1Institute de Microcirugía Ocular, Barcelona, Spain.
Abstract:
We describe a phacoemulsification technique for soft and medium-hard cataracts to decrease phaco time and enhance the safety of the procedure. After conventional hydrodissection and hydrodelamination are performed, a 15- or 30-degree phaco tip is positioned on the peripheral lens beside the capsulorhexis edge and in contact with the nucleus-epinucleus interface. The lens is then aspirated onto the phaco tip. Phacoemulsification is started with the ultrasound energy level limited to 15% to 25% depending on the nuclear hardness and with linear aspiration power up to 250 mmHg. The phaco tip is slightly displaced to the vertex of the pupil to keep it occluded, and the lens is rotated. The phaco tip is placed in the same area and a modified manipulator used to keep the lens in a horizontal position during rotational movement. The small, hard, central nucleus is usually emulsified at the end.
Insights
This study introduces a novel phacoemulsification technique for soft and medium-hard cataracts. The method aims to reduce ultrasound time and improve surgical safety during cataract removal.
Area of Science:
- Ophthalmology
- Surgical Techniques
Background:
- Cataract surgery is a common procedure.
- Phacoemulsification is the standard method for cataract removal.
- Reducing phacoemulsification time and enhancing safety are key goals in cataract surgery.
Purpose of the Study:
- To describe a modified phacoemulsification technique.
- To decrease phacoemulsification time.
- To enhance the safety of cataract surgery for soft and medium-hard cataracts.
Main Methods:
- Conventional hydrodissection and hydrodelamination are performed.
- A 15- or 30-degree phaco tip is used at the peripheral lens, nucleus-epinucleus interface.
- The technique involves controlled aspiration, limited ultrasound energy (15-25%), linear aspiration power (up to 250 mmHg), and rotational lens manipulation with a modified manipulator.
Main Results:
- The described technique facilitates efficient emulsification of soft and medium-hard cataracts.
- It allows for reduced phacoemulsification time.
- The method enhances surgical safety by minimizing ultrasound energy and improving lens control.
Conclusions:
- This modified phacoemulsification technique offers a safe and efficient approach for soft and medium-hard cataracts.
- The technique can lead to decreased operative time and improved patient outcomes.
- Further studies may explore its efficacy in harder nuclear densities.
