Twist Technique to Stop Fluid Leakage and Fixate the Eye During Bimanual Cortex Removal in Phacoemulsification

Leakage of fluid through the side port during aspiration of the cortex leads to instability of the anterior chamber. In addition, eye movement may cause an unintended pulling of the irrigation probe out of the corneal wound resulting in collapsing of the anterior chamber. Both situations could pose a challenge to the surgeon and increase the risk of serious intraoperative complications. Therefore, we describe a simple effective maneuver to avoid these conditions during bimanual cortex removal and viscoelastic washout. In Khaled technique, rotating the irrigation probe outwards causes complete occlusion of the lumen of the side port and a simultaneous stabilization of the anterior chamber. Twisting the incision by the irrigation probe also offers better fixation of the eye at the edge of the side port and a subsequent reduction of eye movement.