[Visco-hydraulic irrigation of the lens cortex. A safe ECCE method]

The safe and effective Hydrojet nucleus expression (Klin Monatsbl Augenheilkd 1993; 202:288-291) should be completed by a safe non traumatic and easy to perform method of cortex removal.

OPERATION TECHNIQUE: 8-mm tunnel incision, spiral capsulorhexis, hydrodissection and viscodissection of the nucleus, hydrojet nucleus expression. The lens cortex can be separated from the lens capsule by injection of hydroxypropylmethylcellulose (Metho), the viscoelastic substance acts as a wedge to separate the cortex from the capsule step by step. Finally the cortex is expressed by the injection of Metho. The capsule remains so clean, that often polishing is not necessary. PMMA lenses with an over all diameter of 10 or 11-mm and 7-mm optics were implanted. In 100 consecutive cases complications which occurred intraoperatively or within the following 2 days were listed.

The following complications occurred: Hyphaema (2x, the blood disappeared spontaneously within 4-5 days), small cortex flake in the anterior chamber (2x), rhexis rim not intact (1x, nevertheless exact lens centration in the bag). No lesion of the capsule/zonule diaphragm, no fibrin reaction, no corneal edema.

The method described is a safe method for ECCE. Capsulorhexis and tunnel incision are required. The method does not need any high technology equipment.