After preparing the patient and phacoemulsification device system, incise the cornea and open the capsule with a continuous curvilinear capsulorhexis using Utrata capsulorhexis forceps under viscoelastic conditions. Perform cortical cleaving hydrodissection by injecting the balanced salt solution or BSS under the anterior capsule flap using a blunt tipped cannula. Perform hydro delineation by injecting BSS into the substance of the nucleus to separate the harder nucleus from the peripheral softer nucleus.
Then select the chop mode, bury the phaco tip into the nucleus center, and insert it under the anterior capsule flap cracking the nucleus into two pieces. Next, set the machine to irrigation and aspiration mode. Use an irrigation and aspiration tip to remove the soft depa nucleus and peripheral cortical material.
Fill the capsule bag and anterior chamber with viscoelastics. Load a foldable single piece intraocular lens into a prefilled injector cartridge with viscoelastic. Now, introduce the injector tip through the incision, and insert the IOL by pushing the injector tail, allowing the anterior haptic to spread into the capsular bag.
Remove the viscoelastic from the anterior chamber while rotating the IOL 360 degrees clockwise with posterior pressure using the irrigation and aspiration tip. Next, insert the irrigation and aspiration tip behind the optic part of the intraocular lens to aspirate residual fragments and viscoelastic inside the capsular bag. After inserting the IOL into the capsular bag as demonstrated earlier, use a Fenzl hook to rotate the intraocular lens clockwise at least 360 degrees.
Slide the intraocular lens within the capsular bag side to side while applying slight pressure on the posterior capsule. A retro illumination image depicting posterior capsule opacification is presented. One year following the surgical procedure, a clear and transparent capsular bag was observed.
