Nucleus-splitting phacoemulsification technique

A technique for phacoemulsification that can be used with or without capsulorhexis and that allows surgery to be performed at the 12 o'clock position is described. Following central sculpting, the nucleus is tipped superiorly to the level of the iris plane with a second instrument and the phacoemulsification tip. The hard nucleus is split from the soft nucleus, leaving two bowl-shaped pieces. The nucleus is rotated and the hard nucleus is removed with a phacoemulsification tip while the softer nucleus or epinucleus is ignored. Once the hard nucleus has been removed, the epinucleus follows easily into the phacoemulsification tip. The technique is advantageous for beginning phacoemulsification surgeons and offers an alternative for very hard nuclei with small pupils.