Corticocapsular cleavage during phacoemulsification: Viscodissection versus hydrodissection. Miyake-Apple view...

Area of Science:

• Ophthalmology
• Surgical Techniques
• Cataract Surgery

Background:

• Phacoemulsification requires effective management of the capsular bag.
• Maintaining corticocapsular separation is crucial for surgical safety and efficiency.
• Hydrodissection is a standard technique, but its efficacy in maintaining separation can be limited.

Purpose of the Study:

• To compare the effectiveness of viscodissection versus hydrodissection in creating and maintaining corticocapsular separation.
• To evaluate the impact of these techniques on surgical stages using Miyake-Apple video-photographic analysis.
• To assess the surgeon's subjective experience of the mechanical cushion effect.

Main Methods:

• Randomized controlled trial involving 14 cadaver eyes.
• Hydrodissection (Group 1) and viscodissection (Group 2) were performed.
• Miyake-Apple video-photographic analysis and histopathology were used for evaluation.

Main Results:

• Viscodissection created and maintained significantly greater corticocapsular separation compared to hydrodissection alone.
• The surgeon's impression consistently favored viscodissection for its superior mechanical cushion effect.
• Residual lens epithelial cells (LECs) were comparable between the two groups.

Conclusions:

• Viscodissection, when used as an adjunct to hydrodissection, offers superior corticocapsular separation during phacoemulsification.
• This technique enhances the mechanical cushion effect, potentially improving surgical outcomes.
• Further research may explore the clinical implications of viscodissection in cataract surgery.